Martin Wolf and Wishful Thinking on Ending Coronavirus Lockdowns

Many commentators have observed that the economic damage of the coronavirus will likely kill more people than the pathogen itself. Too many people then move to arguments like “So let’s isolate only the elderly”1 or “We must therefore minimize damage to the economy.” We’ll turn to Martin Wolf of the Financial Times’ urgings on that front in due course.

The problem is that there are times you can’t have what you want and this is one of them, big time. Our old way of living will never fully come back. And too much fixation on “We need to relax the lockdowns because economy” is bypassing the hard thinking and work that still hasn’t been done enough to help more of us function better before we have either effective treatments that greatly reduce the number of serious cases or a vaccine.2

While China has loosened up on its restrictions, it’s not back to normal due to a combination of some workers reportedly not having returned for duty plus factories not being able to go into full schedules due to lack of new orders thanks to lockdowns in Europe and the US. But there are also rumors that infections have come back. Some countries like Austria, the Czech Republic and Denmark are planning to relax their restrictions in the next few weeks; we’ll have a much better picture a month after that happens of how much reversion takes place.

But the big problem for most countries, particularly the US with its hollowed out health care system and the UK with its starving of the NHS, is that doctors and nurses are already at the breaking point even in locations where the disease has not peaked. Medical professionals are at even greater risk of bad outcomes than the public at large due to potential exposure to large viral loads when exhausted. The lack of adequate PPE is a disgrace and the failure of the Feds to step in, even more so.

There are plenty of clips on Twitter showing the sorry state of hospitals; this is a recent one we featured in Links yesterday:

The National Nurses Union has issued repeated press releases on the lack of preparedness and needed safety protections. Yet the Washington Post showcases Matt Bai putting on an n95 respirator and medical googles (not ski mask made-dos) and other coverings. Not saying that Bai isn’t still taking serious risk, but that the Post is helping propagate the myth that front-line conditions are better than they are.

This video from the Lenox Hill Hospital in NYC (my old stomping grounds) even though taken outside on a pretty day, still gives a sense of the chaos indoors:

Yesterday, we discussed how the coronavirus is leading hospitals to suspend surgeries and treatments they deem to be postponable, even for cancer. We are now getting reports of cancellations specifically due to the lack of PPE:

In the UK, staff at the Barnsley hospital were provided with PPE 19 years out of date

The big point is that a group obviously and seriously exposed to the coronavirus is medical workers. I’ve argued that the big motivation for flattening the curve isn’t just to reduce deaths overall by not exceeding hospital capacity but in particular not to decimate hospital staff.

But as we are seeing from strikes among Amazon warehouse workers and other people who are deemed critical and have to work in close proximity with others, we are risking breakdowns in other now-even-more-essential systems.

And coronavirus is hitting key services where there aren’t many replacement staff, like air traffic controllers. From a late March article in Politico:

FAA personnel at air traffic control facilities from Las Vegas to New York have tested positive in the last week, prompting closures while the buildings were cleaned. The majority of the almost one dozen facilities affected so far have been towers at airports, but two of the incidents have been at centers responsible for controlling airspace over multiple states.

Though the airports themselves remained open, buildings had to be closed temporarily and control duties taken over by another facility, creating delays even in this depressed environment for flights. A cascade of more cases spreading throughout the controller community, especially if it hits several facilities in one region at the same time, could be crippling.

How about the staff that manage nuclear reactors? Sewage plants don’t take as much day-to-day minding, but prolonged staffing shortages could lead to bad outcomes. Readers might come up with other examples of important infrastructure or systems that would have trouble functioning well if a site or sites were to suffer a coronavirus outbreak.

Steve Waldman made the case for enduring the cost of lockdowns in a post last month:

COVID-19 is not just a disease that is infecting us as individuals. It has infected us as a society. The financial fallout, the flailing markets, these are the social equivalent of a mid-grade fever, an unpleasant and uncomfortable side effect of the work our society is performing to suppress and defeat the infection. There may be ways of reducing the unpleasantness without impairing the effectiveness of the response, various forms of economic stimulus or monetary loosening as a kind of social tylenol. Maybe those are worth considering. Some have been tried. But nothing would be more stupid, more suicidal, than to suppress the immune response in order to suppress the fever.

That is what ending our isolation now — what sending everybody back to offices, schools, restaurants, beaches, and bars — would amount to. It might well relieve the “fever” short term. The stock market is up this morning! But it radically increases the likelihood that the patient — our polity, our society — dies.

How would that happen? What’s the microstructure of this purported social collapse? How would putting people to work again be bad?

We desperately need people to work. All of us staying home will not save us. But some people’s work is much more critical than others’ to our society’s collective viability. We obviously need medical personnel to work. For them to work effectively, we desperately need the people who are capable of producing and ramping up production of PPE (“personal protective equipment”) to work. Perhaps more desperately, we need our agricultural and food supply chain to be producing the calories and nutrients each and all of us need to get through this. We need grocery store clerks, stockers, shoppers (for delivery and pick-up orders) to work. We need truck drivers a-truckin’. We need Amazon and UPS and FedEx, permitting us to get what we need with minimal opportunity to cough on one another. We need fire departments and police. We need the digital platforms and communications infrastructure. We need people delivering essentials to the elderly. We need the people who can develop and ramp up testing, tracking, and treatment. We desperately need people to work.

But if you are not one of these people, your staying at home — working as much as you can if you can or not at all of you can’t — is not “waste”. It is making a huge positive contribution to our society, by delaying the moment when it will be impossible to persuade a critical mass of these very essential workers to do their jobs, because many of them are sick and the rest of them are too afraid of getting sick.

The New York Times ran an article on Monday based on interviews of medical experts on what needed to be in place to relax the lockdowns with reasonable safety. Its four requirements:

Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care.

A state needs to be able to at least test everyone who has symptoms.

The state is able to conduct monitoring of confirmed cases and contacts.

There must be a sustained reduction in cases for at least 14 days.

Needless to say, the US is not even close to meeting these standards. From the close of the story:

Gregg Gonsalves, a professor of epidemiology and law at Yale, said: “I’d feel better if we had serological testing, and could preferentially allow those who are antibody positive and no longer infectious to return to work first. The point is, though, that we are nowhere even near accomplishing any of these criteria. Opening up before then will be met with a resurgence of the virus.”

A lot of normally capable policy wonks seem not able to come to grips with the fact that the coronavirus has the upper hand. Sure, we can try reopening for business after we’ve tamped down the infection and death rate with stay-at-home requirements. And maybe the disease won’t propagate quite as quickly because the summer will have a mitigating effect.

But I have yet to see an expert opine that warmer weather will do all that much for contagion rates. And I also know too many people who seem to have convinced themselves that they already contracted it, when the second go-round of the past winter’s flu was nasty and I know personally of only one symptom description that does sound like it was coronavirus. In other words, a lot of people seem to feel the need to tell themselves they aren’t at risk when their personal factoids are far from dispositive.

So what happens to commerce if restrictions are largely or entirely removed, and in a month infections are back on the march? The resulting stops and gos, particularly at different times in different parts of the US and world, would make the production that was happening more uncertain and likely costly.

The reluctance and inability of Federal or even state governments to set priorities and drive resources and support to critical industries and operations, like America’s one cotton swab factory in Maine, is yet another proof of institutionalized incompetence.

With this backdrop, it’s frustrating to see Martin Wolf engage in handwaves. From the top of his article:

What we must do instead is focus on the steps right ahead if we are to avoid falling off our narrow path into mass deaths on one side, or economic devastation on the other. If we do not avoid these calamities in the near future, we risk chaos ahead.

There may be no path through this problem. If you watched the video of the professor who practices at Lenox Hill, he argued for the need to build Covid-19 focused hospitals, all with negative pressure treatment rooms, with the medical professionals in them wearing full hazmat gear, as essential to contain the disease. If he’s right, we are in deep trouble.

Wolf is correct to stress that the economic costs of shutdowns are very high…

….and that the poorest workers and countries will suffer the most.

His next argument:

My view, however, in line with that of health experts and leading economists, is that the lockdowns are necessary to save health systems from collapse and get the disease under control. But they have to be brief. It is impossible to keep people locked up indefinitely, without huge personal suffering and social and economic damage. This is obviously true where governments are unable to offer the costly social protection measures feasible in high-income countries.

Lockdowns must be a short breathing space before we move to what a group of German experts calls a “risk-adapted strategy”. During the lockdowns, governments must do whatever is needed to avoid having to employ such heavy-handed interventions again. They do not have much time to do so: a few months, no more.

Go back to the New York Times’ list. In China, even with its extensive spying technology, it allegedly took 1800 teams of five each to do contact tracing. And it’s not clear that that was a prime defense weapon even outside Wuhan. Please tell me how prepared the Federal government or any state would be to devise such an effort and staff it on an emergency basis.

In most major cities in China, people weren’t allowed out of their apartment buildings if they had a fever (there were monitors at the exits). That form of control is not an option in spread-out America.

Wolf may nevertheless correct about how things will roll even if offices and retail establishments are kept largely closed. A reader in NYC reported that more people were on the street yesterday, wearing masks, apparently of the the view that adhering to the CDC guidance increased safety enough to allow them some liberty. The reality is being outdoors where droplets diffuse quickly is a very different proposition than being indoors or in a vehicle.

So the authorities probably will not have the resolve to keep the lockdowns on even if public health experts mount credible arguments that it’s too soon to go into “Mission Accomplished” mode. Expect a very bumpy ride.

1 In case you haven’t sorted this out: First, models show that isolating the elderly only trivially reduces infection rates. Second, you can’t isolate them. They have to eat, see doctors, go to the bank, get their cars and houses fixed if they live independently or be attended to by younger people if they don’t. Third, younger people are still getting bad cases and dying, and even those who get bad cases and don’t die often do suffer lasting heart and/or lung damage. See this video on how the UK is seeing a lot of ICU cases of people in their 50s and younger:

Fourth, letting the disease rip puts the immunocompromised and those with other morbidities like diabetes at risk.

2 It would be better if I were wrong, but I am concerned that the jury is out on herd immunity. While getting Covid-19 does confer short-term immunity, some experts are worried that it may not last as long as a year.

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  1. Tom Stone

    Thank you for expressing the danger so clearly and so calmly.
    The number of peope I have spoken to who are convinced that once the peak of new infections of the first wave has passed
    “We can go back to normal” is frightening.
    It’s not going back to where things were, ever.
    Failure to recognize that it will be many months and perhaps a year, before we have a handle on this virus makes societal collapse a very real possibility.
    If the reaction of those “In charge” doesn’t scare the shit out of you you are not paying attention or you are delusional.

    1. Tim

      What is the pain threshold, is the key question. When people start to perceive the threat of societal collapse as real and present, then all the preconditions of the medical community will go out the window and survival of the fittest will go into effect. As ugly as that would be as described above, it would be better than complete Libertarian utopian anarchy. People with lots of guns and private insurers and bankers pillaging what is left of society.

    2. juliania

      “Lockdowns must be a short breathing space…”

      There’s the answer. I’m elderly, and I have stayed home from the very first as my only access to stores is via public transportation. My kids shop for me at present, but that takes up some of their own precious time.

      The solution is this. We elderly have time on our hands and we also have plenty of cloth, old cloth even. Which folded a number of times can be made into a serviceable mask. Mask up! The new lockdown will have to be that. If you use public transport, have at least a thick bandana, or scarf wrapped tightly around your face (make sure you can breathe). And gloves. The cotton gardening gloves are good and cheap, so you get home, drop your mask into the wash, follow with gloves, and wash your hands. And that mask is going to be your second nature whenever you go outside the home. Make it a comfortable fit but tight around the face.

      Make that mandatory. It’s not only to protect others; it’s to protect YOU as well. Hand out fines to the unmasked!

      I want to ride our bus again; this is what I am going to do. You see that odd looking old lady out there with a trundler and a bright turquoise mask with stripes? That’s me!

      1. Anon

        Masks are now mandatory for all that are moving about in public space, in Riverside County, CA. (Inland and not by any river.) Mask making and mask templates are all over the Internet.

        Stay safe, Juliana.

  2. russell1200

    Schools being out is probably the largest thing you can do. The whole “seasonality” of the various cold viruses is due to the timing of our school sessions. If this corona virus does wind up being humidity/heat sensitive, shifting school sessions to avoid winter-sessions might help.

    It isn’t just the folks at the power plant. There are far more people involved in maintaining the delivery system. And the people that in some fashion get fuel to the power plants. Or in the case of water supply the delivery and the waste removal. Baseline household water usage has 12% of “usage” as being leaks. Imagine how bad the gets if you don’t have maintenance or repair.

    1. Anon

      Yes. Sewage treatment plants are actually individually unique systems staffed by technically astute engineers of different stripes. (My town, with a treatment plant that produces millions of gallons per day of tertiary treated effluent for re-use, is keeping it’s staff isolated/protected in nearby hotels (which are empty of tourists))

      The treatment plant needs a large amount of chemical products and truckers to remove sludge to distant lands. The treatment process consumes annually 59% all electricity of municipal services. No power no treatment. Essential personnel is broader than we think. The expertise required to operate municipal functions is not fungible.

      1. periol

        It can even be very small things. A few years back the town of Corona del Mar in California had to tear up a series of water pipes running across Pacific Coast Highway in the downtown area – which meant they had to dig up PCH a section at a time. Took a while, to say the least. I talked to the foreman, and he said the pipes were 7 years old and should have lasted 40 years, but the yearly routine maintenance hadn’t been done, so they had to redo the whole thing.

        That was incompetence, because the town could definitely afford the maintenance. But there is quite a bit that can go wrong quickly if the right people get taken out. Those were water pipes – the water coming out of faucets was brown with sludge. Wouldn’t take much for that to scale out across America’s infrastructure…

  3. PlutoniumKun

    A few random thoughts on this:

    A major problem with the ‘let it rip through and just protect the old folks’ line of thinking is that we still don’t know exactly what this virus does to peoples bodies. There are credible reports that recovered patients are suffering from heart and neurological issues. It’s vital to minimise infection in all the population for as long as possible to give time to develop better treatments and vaccines. Weeks ago Nicholas Nassim Taleb recommended that all those who advocated for herd immunity should be injected with Sars2 immediately, since they were so keen to get it over with. He had, in his usual blunt manner, a point.

    On the interview with the NY hospital and the need for dedicated Covid hospitals – a forgotten lesson of history is that infectious diseases need special hospitals – TB in particular. This was both to aid treatment and to ensure separation from other patients. There are numerous former TB sanitariums around the world which may just find themselves repurposed for this (one is just down the road from where I live now, its currently used as a recovery hospital for serious neurological cases). This is a major argument for centralised health systems – its much easier to reorganise your hospital system if you don’t have to deal with a complex network of private providers. This type of reorganisation is already well underway in most European countries that I’m aware of, but it will be extremely difficult in the US for obvious reasons. In my own country, Ireland, the military have already been involved in emptying out some smaller hospitals so they can be repurposed as specialist units for cancer patients in order to keep them well away from Covid patients.

    As to the overall economic impacts on this, I believe that supply chains and vital services can be kept going – but only if the spread of the virus can be flattened out over a year or so – any organisation should (I would hope) be able to deal with 10% absenteeism. But this needs very careful management and planning – some countries will be able to do this, others will find it impossible. We are about to have a large scale real time experiment in institutional robustness worldwide. We may find some very surprising results.

    1. Jeremy Grimm

      A few random thoughts on your random thoughts:
      Where and how did the “herd immunity” idea get started as a way for dealing with the COVID-19 pandemic? I cannot imagine anything more stupid than that. What rancher would deal with disease in a herd of his beef-cattle by “herd immunity”? And yet public officials and the press repeat this idea. Do they value the ‘herd’ of workers and common people less than a rancher values his beef-cattle? I also strongly agree with your point that “we still don’t know exactly what this virus does to peoples bodies”.

      A dedicated Covid hospital makes sense, along with proper PPE for health care workers. The trouble working this idea for the U.S. — we don’t have enough PPE and remain unable to produce it; we didn’t have enough hospital beds before Covid; we don’t have enough doctors and nurses or other important hospital staff; and we have too many hospital administrators — besides who can afford to get sick with a cold in the U.S. … and hospitalization, that is a sure road to financial ruin. We should have dedicated Covid hospitals and maintain them after this run of Covid because this will not be the last pandemic flu or disease we might have to deal with in the future. There is so much we should have but don’t.

      In my opinion the overall economic impacts of this pandemic will be broader than the issues you identified of institutional robustness, “very careful management and planning” and so on. The fragilities of our supply chains were well-known over a decade before the Covid pandemic brought them to the public’s vague attention and concern. I don’t know enough about other countries to speculate — in the U.S. the CARES Act and the further ‘stimulus’ packages promised for the future leave me very worried about how the U.S. economy and politics could devolve. The U.S. response to the Financial Crisis of 2008 leaves little reason to hope for how the U.S. might respond following the Covid pandemic and associated financial crisis.

    2. John Wright

      The New York Times had an op-ed from an academic Hong Kong doctor that was featured in NC Links yesterday.

      “We need to hit and release the brakes on physical distancing, again and again, until we safely get to immunity.”

      Per the article “The Covid-19 pandemic can only be prevented from resurging when at least half the world’s population has become immune to the new virus. And that can happen in only one of two ways: After enough people have been infected and have recovered, or have been inoculated with a vaccine.”

      Essentially the op-ed seems to recommend that a huge portion of the USA population needs to acquire Covid-19 (50% of 320 million = 160 million in the USA) if no vaccine is available.

      But modulate (turn off/ turn on) the social distancing requirements to avoid overloading the medical system.


      If more effective treatments are not found, If the death rate is about 1.3% this means about 1.3% of 160 million will die (about 2.08 million), and a portion of the recovered population may have long term damage to their bodies..

      Using the doctor’s logic, the USA citizenry will be doing social distancing a long time, simply because the USA’s costly medical system can’t handle the medical demand generated by “lockdown off”.

      Perhaps there will be a new program where the US Government runs a televised lottery to randomly select 50% of US Senators/Representatives/Trump administration officials and draft them in the new Save The USA Economy, acquire Covid-19 immunity by getting the disease.

      Message to our leaders, Uncle Sam needs you (to develop immunity)!.

      1. Nick Alcock

        There is no third option. Either we all become immune to it through vaccination, or it’s infectious enough that we *will* catch it eventually, and become immune that way (or die of it). Of course, if like some other coronaviruses the immunity doesn’t last and you can catch it again in a few years, and if it’s just as bad the second time, this all looks much bleaker; a Russian roulette in which sooner or later you are unlucky and drown on your own immune response or it infects your heart and gives you heart failure.

        The good option is a new every-few-years *mandatory global* vaccination program for this thing. If this sounds wildly impractical in some parts of the world, well, yes.

  4. divadab

    IN my rural township there are a husband and wife, both doctors, both Covid-19 positive and with minor symptoms, who are in quarantine at their weekend cottage from their hospital jobs for ~two weeks until they are non-contagious. Then they’ll go back to work, immune to the Covid-19 virus.

    Surely this is the model for recovery absent a vaccine? This thing is in the wild now and working its way through the population – and between 50-80% of infected are symptom-free or have minor symptoms. Yes some people are at greater risk and they should self-isolate – but over the next month or maybe two there will be more people recovered and immune and life can go on. Let the young people work and let the old people stay home and isolate until there is a vaccine.

    This thing is NOT the plague and I’d rather get it now and have immunity than wait til next-year’s version, potentially much more deadly, and face it without immunity. I’ll take the 0.4% risk – it’s much lower than the risk of complications from the simplest procedure such as a colonoscopy. That said, I am following the protocols because I really don’t want to get sick – but the lockdown IMHO is too extreme and idling people who are at very low risk from this thing who should be working.

      1. divadab

        Well it could be three weeks but I don’t get your argument – are you saying they won’t be immune once recovered?

        1. Yves Smith Post author

          We have made the point repeatedly that there is no certainty that any immunity lasts longer than a few months. Even Fox in trying to be upbeat about how things were going had an MD point that out.

          We have no cure for the common cold, which is also a coronavirus, because the immunity lasts less than a year.

          1. Nick Alcock

            We have no cure for the common cold because hundreds of very different viruses have nearly-identical upper-respiratory symptoms. Two of them happen to be coronaviruses (though most colds are not caused by them), but as far as is known (and not much is known: the viruses themselves were only discovered quite recently) the immunity might last for up to a decade.

        2. funemployed

          One of the guidelines of this site is that you must read the article in its entirety and engage in good faith argumentation if you disagree with any portion of it.

          It is obvious you have not done this, as nearly all of your claims have already been addressed thoroughly by Yves.

          Please do read the article. It’s quite good.

      2. Reality Bites

        This seems like wishful thinking. Firstly, young people are nearly as much at risk as the elderly based on the hospitalization numbers. Sending people back to work without a much broader testing regime is begging for a massive spike in infection. It defeats social distancing and the suite of measures that help to flatten the curve.
        Moreover, hoping that an office can deal with 10% absenteeism? Anyone that tests positive will cause a chain reaction of quarantines for all around them and could devastate whole teams. The workforce has also suffered from the same “efficiency” drive that the supply chain did. There are not many surplus workers in most offices, especially professional/white collar jobs. It is highly unlikely that companies can cope with that approach.

    1. Yves Smith Post author

      It’s not 0.4% risk. Agnotology is not on here.

      The deaths are very much understated, so you need to adjust those #s up big time as well as the number of cases. El Pais today reports that the death rate in Madrid above normal levels suggests that the coronavirus death rate is 2x what is officially reported. Translation courtesy Ignacio:

      Los datos de entierros en Madrid apuntan que las muertes por coronavirus pueden ser 3.000 más que las de la estadística oficial
      Burial/funeral data suggest that Covid-19 official deaths counts could have been understated by 3000 in Madrid province.

      Between the 14th and 31th of March civil registry offices recorded 9,007 burial licenses (about 500 per day). This contrasts with total deaths registered in March 2019 by the Spanish Statistics Bureau (INE) of 4,125 (or 133 per day). It can be concluded that between the 14th and 31th of March 2020 there were about 6.600 deaths in excess compared with 2019 while official numbers account only 3,349 Covid-19 casualties in this period. This strongly suggests heavy under registration of Covid-19 associated casualties.

      The Economist separately points out that the death rate looks higher than official results:

      Anyone who dies at home or in a nursing home will not be counted as a Covid-19 death unless (and even then this is an if) they tested positive in a relevant time frame.

      The CDC confirms:

      Deaths due to COVID-19 may be misclassified as pneumonia deaths in the absence of positive test results, and pneumonia may appear on death certificates as a comorbid condition…

      Provisional counts of deaths are underestimated relative to final counts. This is due to the many steps involved in reporting death certificate data.

      A recent study finds a CFR of 1.4%

      In Italy, it was 7.2%:

      And I suggest you read up on the disease. Coronavirus is a very bad way to go. About 15% get serious cases. And as PlutoniumKun and more recent reports indicated, a disconcertingly high proportion of those who get bad cases survive with serious pulmonary, heart, or neurological damage.

      As Taleb said, if you are really so eager, why don’t you get yourself shot up with the disease?

      1. Yves Smith Post author

        I also did not get into the inaccuracy of testing if you test only once. See this paper from a statistician:

        You can see that there’s going to be a lot of mistakes in classifying coronavirus cases—probably a lot of false positives, especially in initial testing….

        The conclusion is that it’s nuts to implement large-scale testing on a population. It will lead to huge numbers of false positives—which will be everywhere painted as true positives—and more panic.

        The flip side of “lots of false positives” is that the number of supposed mild or asymptomatic cases include lots of false positives, so the death rate is higher than you think.

        Now having said that, I understand people are being tested twice for precisely this reason, since his warning applies if you test only once, but I have zero idea of how common this practice is here and in other countries.

        And before you get all cheery reading his paper, a commentor took the air out of it by looking at his assumptions:

        Briggs looks at the threat with the numbers very low. That’s not very interesting if we allow the numbers to go up by 4 orders of magnitude or more

        1. Bob

          Not sure if this is true or accurate however in our midsized community there are rumors that the tests are not uniformly accurate. Further that there are large discrepancies between test suppliers.
          This leads to tests being made multiple times on the same patient.
          Which in turn reduces the number of tests available

        2. vlade

          Because of the false positives, in CZ positive cases are tested twice I believe, with a period in between. This actually inflates the number of tests. For example, in the a couple of days back that there was about 7000 tests, of which cca 1000 were re-tests I believe.

          I do not know whether other countries retest, but if not, then yes, you can easily get a lot of false-positives.

          1. Ignacio

            False positives by NTA mean bad testing/sampling practices rather than test failures. These tests should be done with internal controls but I guess that this is not always the case.

            1. vlade

              Yes, I believe it’s the sampling practices that are in doubt. As you know, RT-PCR is extremely sensitive, so sample contamination is a problem..

            2. Yves Smith Post author

              Please read the paper, which (and I hate hectoring you) it is clear you have not done. His point is about what a positive test means for ANY test given a base rate (how many people have the ailment). This is not at all about the accuracy of the tests. He goes through various assumptions re test accuracy.

              I ran this by Cathy O’Neil, aka mathbabe and the author of Weapons of Math Destruction. She didn’t find anything amiss with his analysis save the assumption of a single test.

              1. Jabbawocky

                What is interesting about test results in the U.K. is that say for April 7th we are reporting circa 14k tests on circa 12k people with around 5.4k positives. This ratio has remained more or less consistent.

                Note the U.K. is mainly testing people that turn up in hospital with symptoms resembling Covid-19.

                This essentially means that around 50% of people with severe symptoms have the virus, ie even with lockdown we are seeing a doubling of usual pneumonia cases.

              2. Ignacio

                I disagree with the analysis which is theoretically correct but not true because it relies only on assumptions on sensitivity and specificity. Real Time qPCR, when correctly designed, in many cases yield 0 false negatives (excluded internal errors). Bear in mind that this is not a simple test it is a combination of at least 2 tests in one designed to increase both sensitivity and specificity. Next paper shows examples of 100% specificity tests as well as others badly designed and not so specific
                The WHO RT-qPCR kit has been tested for both sensitivity (very high, not in percentage terms of subjects but on the number of genome copies needed for positive results) and specificity (false positives from internal primer reactions or cross reactions with other virus or clinical samples) and it is very high. False positives could be relatively high in China if, and only if (and this is possibly a case) there are some harbouring non Covid Bat CoV derived infection because the sets of primers detects SARS-like virus. By the way these would be interesting to analyse massively. Whether there are SARS-like virus in other regions would also be interesting so massive testing could prove really useful to see the extent oof the potential of SARS zoonosis around the world.
                This was assayed on a collection of clinical samples from patients with a variety of common respiratory diseases resulting in 0 false positives. This is not theory but practice with real samples.

      2. Wyoming

        The coroner in one of the counties in Wyoming (the state which supposedly has no covid deaths) has said that he has 13 subjects he thinks died of covid but they were never tested due to lack of tests. This situation is everywhere in the US just like in Europe. Sometime down the road from now researchers will scrub data like that from Madrid above and get a fair statistical estimate for the developed world of how many died. But I can only imagine what a mess is going on elsewhere along these lines. Note the item in the news from several days ago concerning Guayaquil, Ecuador where residents are taking the bodies of family members and putting them in the street wrapped in sheets since they are starting to decay and no one will come pick them up. What will happen in the rural 3rd world.

    2. Gerrard White


      Everyone, bar a few, is panicking one way or the other, as if this virus a) was an unknown but maybe worse than so far known or….b) we have to get it solved or find a way to overcome it, and afterwards then all those other ones backed up waiting their turn (as far as we know this is certainly very possible that there are many, Africa, Amazon)

      Someone, then a lot of people are going, sooner rather than later, respond as you do – for a bug which kills surprisingly few people, very nearly all of them old and pretty sick with other ‘conditions’, or even if one is surprised, then a door to door re conditioning of modern life under capitalism is neither possible nor, for most, wanted, nor a suitable goal

      capitalism seems to be a very determined and long chain virus in which all elements are closely inter related and dependent on everyday mutation and re invention against which a widely effective vaccine has yet to be found – but heck perhaps this bug is actually that vaccine

      Even if a vaccine is discovered, eventually, will this work against the next wave or iteration of a related but perhaps nastier bug ? can any economy plan and stockpile for a genuine ebola or related pandemic?

      Even here on this site there have been ample reports that ind-ag is to blame, not only in US but worldwide: turning that food industry and the lazy health habits and standards of the industrial world populations around – if even conceivable -is going to take a very long time

      Super surveillance quarantining distancing etc is a band aid, and as many have pointed out, it’s not an easy argument but why not argue it – why adopt solutions which seem guaranteed to kill more than they ‘save’, just because such solutions ‘war on bug’ read for war on terrorism, merely allow government to throw more capitalism at the problem which never goes away but makes life for all nastier, and once again deprives individuals of autonomy and agency

      Ebola is bad enough, is it impossible to imagine something ten times more fatal and swiftly so than ebola?

      Who’d have thought climate change would look so easy

      1. Yves Smith Post author

        I’m not keen about your characterization of “panic” as if it were general and unfounded. MDs who are seeing patients ARE very worried. For instance, Matt Bai, who treated Ebola patients, said he was more scared about Covid-19 than Ebola (perhaps because everyone treating Ebola was suited to the max and hyper careful while with Covid-19 the doctors and nurses don’t have the PPE and resources to operate to those standards). The fact that MDs and nurses on the front line are hugely fearful for themselves and their families to me is the most telling evidence of how serious this is.

        In my case, I will confess to being worried because I have a 92 year old mother with COPD and her aides or I could kill her. Are you going to charge people with neuroticism for not wanting to see close relatives die a horrible death, made even worse if they can’t get palliative care because hospitals are overloaded?

        1. Gerrard White


          panic is, as far as I know, defined to be general and unfounded, in the sense of un useful & as detached from a reality which is only new but not in any sense unknowable

          whereas fear of something is often fairly useful, panic is the opposite

          One can be worried, yes – ebola was sort of well known and defined, even if very much more deadly – worrying still but so less panicky making for that – and every reaction to e- seemed as far as I remember was along the track and trace lines which worked so well with previous bugs from China, in the case of e- even in the depths of usually condemned as backward Africa

          Nurses this time are worried because no one knows what they are doing, whereas yesterday they did in very parallel situation know – who profits from this stupidity panic and for what purpose?

          Pretty much every gvmt lost the plot and p-, despite successful containment measures previously exercised on previous outbreaks, and there being no grounds for thinking this bug one would be much much worse (there still is no reason to suppose it will be that much worse)

          It’s that panic which has adopted the war on terrorism solution, which is guaranteed to fail, no matter how much adequate science and ok ish technology are thrown at it, wrecking the economy while merely increasing the current dire imbalances in capitalist structure and superstructure titling it very favourably once again towards increasing the ruling class dominance and wealth – how likely are travel costs to remain low, how many factories will re open, how much more of the economy will be eaten by zero hour contracts

          unemployment at 2019 times ten? times 20? how many people does that kill?

          ruling class opportunism builds on the sincere efforts and advice of doctors, likes nothing better than the backup of technocrat expertise to justify their quarantine slides into martial law, prioritising of patient categories, essential and non essential workers is extremely reminiscent of totalitarian language, it’s for your good own security is their favourite slogan

          Instead – improve physical heath and hygiene and eating habits especially, find ways of accepting some things are not possible entirely to control, start disassembling ind-ag, stop feeding everyone quite so many drugs

          They closed the Churches in Rome – (correct me if I am wrong) this has never been achieved since the dawn of Christianity in that town, neither the Vandals, nor the Goths, nor the Huns, nor the French, nor the Nazis, no barbarian ever managed what the current barbarian did at the flick of a switch

          Far too many people are salivating at the chance to rewrite the rules and usher in great new plans for a great new world while making half hearted appeals to the experts say we have to alibis : all this is very 1961 Nuclear War scare come true this time

          1. Andrew Gordon

            Thank you…I am much more panicked about the economic fallout than the health crisis. My neighbor across the street already has a foreclosure notice on his door after missing the April 1st payment, only…and he has two friends MOVING IN, for the 30 day grace period I presume, as they’ve been evicted from their apartments. Things are getting ugly quickly for the majority who live paycheck to paycheck. I’ve also been asked about attending a “meeting”, by a gun-toting neighbor; I’ve politely declined, for now, although I’m not crazy about sitting in my home & starving to death because the elite has declared martial law to protect their own health (“It’s what the doctors said that we MUST do!”). In my estimation, there’s about four more weeks where the health panic narrative will be dominant. A MAGA hat-wearing co-worker has taken to ending his conversations with “See you on the bread lines.”..and he won’t be voting for Biden in November either (a Calculus Sanders might have changed).

            I’ve also given thought to a couple of acquaintances who were relatively sick for a couple of days in February, one in Queens, and the other a shut-in in Louisville. It’s quite possible that COVID-19 has already propagated itself much more widely than currently believed, during the pathetic early stages of government inaction. The country needs some sort of national testing program to get some data in order to get some parts of the economy functional again. The data points are all over the place, but just looking at today in the US, there’s a 3% fatality rate, plus some reports of younger people in hospitals (though that may be because older patients with the virus die sooner, such as in the news of New York seeing a ten-fold increase in people found dead in their homes, exclusively older people). But looking at the 3% number, any asymptomatic/mild/medium case rate, including my two acquaintances, who got ill, but haven’t gotten tested or treatment, would significantly cut into that fatality rate. Even Yves’ numbers in a previous comment (of total known cases, a 1.4% CFR & a 15% serious case rate), gives an actual CFR of 0.2%. Even adjusting that higher by looking at other data points, such as non-tested nursing home deaths, one can adjust that 0.2% number lower again because many who suffered a “quiet” mild to medium case have never been tested.

            Ultimately, Wolf provided a framework for an alternative plan that can avoid a much worse crisis.

      2. Tom Bradford

        “Everyone, bar a few panicking…”* Where? I don’t see it. I see worried people. I see people taking action to protect themselves and their families that makes sense at the individual level even if it doesn’t help at a social level, ie ‘panic’ buying. I see people trying to assimilate and assess what they are hearing, and reacting as they see fit, the effectiveness of which will depend on the accuracy and reliability of the sources available to them or that they select. What I’m not seeing is a lot of “hysterical or irrational behavior.”

        I’d propose that your argument – which essentially comes down to sacrificing the few in order to preserve the status quo ante of the many – is a rationality as dangerous as panic. I’m glad I can believe that most people are aware enough to be able to see that panic is neither desirable nor necessary, yet human enough to eschew the cold logic of the spreadsheet.

        *”Panic definition, a sudden overwhelming fear, with or without cause, that produces hysterical or irrational behavior, and that often spreads quickly through a group of persons or animals.”

    3. Bsoder

      “50-80% of infected are symptom-free or have minor symptoms”, that seems to be more of an friendly reminder in times of uncertainty and misinformation: anecdotes are not data. (good) data is carefully measured and collected information based on a range of subject-dependent factors, including, but not limited to, controlled variables, meta-analysis, and randomization. That data to date show max 20% of people are asymptomatic. Current data shows length of time one can be infectious can be as long as 21 days, with some people 1-2% being infectious after that. As to heat infecting the virus, well the body is at 98.6°, but many warm weather countries have sizable infected populations. But it’s more than that, the make up of CV19, specifically the corona is not all that heat resistant, but the data shows it is enough. Warm weather won’t decrease human to human contact. It would be helpful if people thought of CV19 as not the flu.

      1. Tim

        existing data per Fauci indicates somewhere between 25-50% of cases are asymptomatic, which I still feel is likely a good thing. It means the death rate is actually lower, and IF there is to be herd immunity it will come quicker.

        1. Kurtismayfield

          The only way to know this is to random sample different populations, which is not happyening So everyone is grasping at whatever best guess that fits their narrative.

          1. jonboinAR

            I agree. We have no clear idea what percentage of the infected population remain asymptomatic, or for how long. We don’t know it people who have had it have immunity after recovering, or for how long. That means we have no clear idea if there can be such a thing as herd immunity. We don’t know if the recovered are now as healthy as those who have recovered from a flu or cold, or if corona-virus implies long lasting health issues. Anyone who makes any predictions based on pretending to know much about corona-virus besides a couple of general things like it’s very infectious and seems to kill quite a few sufferers is lying or, most likely, thinking wishfully.

          2. Tim

            Fauci referenced random testing in China and New Zealand and possibly one other country in his SWAG. FWIW

          3. Nick Alcock

            This has been done in Iceland, and it showed ever higher rates of asymptomatic infection the younger you got: the peak infection in Iceland was working-age adults, 30–50, about 80% asymptomatic or nearly so. But the peak among those *turning up in hospital* is twenty years older.

            This is, of course, a good thing if replicated, because it means that the death rate is much lower and many more people have been infected (and are, at least for a time, immune) than was previously believed. — but, fog of war: the opposite result has been seen elsewhere, though with different tests and much less testing.

    4. Phacops

      You cannot make that presumption of immunity until there is clinical testing for immunoglobulin (G) serum titre and followup for reinfection. We are not anywhere capable of that in our for-profit medical system as is clearly evident by the fact that we are in our current situation by putting profit ahead of resilience of care for all our communities.

      Even with the 4 most common coronaviruses that cause respiratory infections (the common cold) immunity is frequently weak and not long lasting. Magical thinking will not promote immunity. Rather, what this pandemic is demonstrating is that class/social inequalities in the lack of adequate provision of healthcare to all Americans creates the underlying health issues that make class and race factors in COVID comorbidity and risk of death. Want to recover from this and prepare for other zoonotic diseases in the future? Then, we need universal healthcare that is free at point of use to encourage use and prevention.

      But then, looking at the morbidity and mortality figures by race, it is clear that inequalities in healthcare within the black community have had a negative impact: in Michigan while only 14% of the population, blacks make up over 40% of the serious COVID cases. One wonders at their leaders and voters who have overwhelmingly supported Biden who promises to maintain that health care inequality.

      1. vlade

        As you say, we have no idea how long the immunity lasts (FFS, we can’t even test properly and reliably for the antibodies to show people were infected!)

        In addition to that, if there are mild/asymptomatic cases, they will NOT build antibodies, because it will trigger only their innate immunity system. The adaptive system has a trigger when it’s clear that the innate system can’t cope. Which is not when you’re asymptomatic or mild.

        We do not know enough about the virus yet. Any “herd immunity” and similar claims are BS.

        1. Nick Alcock

          In addition to that, if there are mild/asymptomatic cases, they will NOT build antibodies, because it will trigger only their innate immunity system. The adaptive system has a trigger when it’s clear that the innate system can’t cope.

          Cite? I’ve never heard of this before, and my understanding of the adaptive immune system doesn’t suggest that any such thing is even possible. What the adaptive immune system does have is a slow ramp-up when faced with a new pathogen: you have to wait for a B cell to spot that it sort-of-fits an antigen and then wait for it to replicate madly hypermutating until one is produced that fits it precisely, then you have to wait for that to replicate up without hypermutation, and only then do you get a useful antibody response. And eukaryotic cell replication is not exactly fast (by the standards of bacteria anyway) so this takes a good few days at best.

          So it is often true that a pathogen will be cleared out before the adaptive immune system even notices it, much less ramps up to a full antibody response: this is usually the case for small-scale infections of cuts and the like. But that doesn’t mean the adaptive immune system is watching for signs the innate immune system is overwhelmed and triggering on that: it just means it’s a relative laggard.

          (I could be wrong, of course: the immune system is huge and complex and I’m a few years out of date in my knowledge of it, which was far from complete even then.)

      2. Anon

        Hmmm. I wonder if the South Carolina primary or Super Tuesday would have gone Biden’s way with today’s data in hand. Today is the day Bernie ended his campaign.

    5. CallMeTeach

      Let’s say that there is a reliable serology test and anti-bodies lasted for a substantive time (Neither of which we have at the moment.) There’s still a flaw in the reasoning that those who’ve been exposed could go back to work while the rest are protected: if given the choice between starving and getting sick, people will go out of their way to get the virus so they can go back to work. There will be COVID-19 parties, a lot like there were chickenpox parties prior to the vaccine, and there would be a concomitant spike in hospitalizations and deaths. This is the untenable situation many would be in. Get sick and risk death or slowly starve, be evicted, etc. The ONLY way for the “protect the old and weak” scenario to work would be if those who had to remain home were paid more than just a pittance to do so (and we had the requisite serology and immunity).

    6. J.K.

      So you would take a 1 in 250 chance of survival. Last week , I won a scratch off for 100$, chances of that were 1 in 30,000. But hey, you do you.

      Please look at page 6. This has projections on total population infected in different countries . It ranges from only .4% for Norway to the highest of 15% for Spain.
      I had to dig this up for people who keep arguing, without any data, that the majority of us are infected and are already heading towards herd immunity. So we may as well “open the country”. This is the line some commentators on fox are peddling to their viewers.

    7. rosemerry

      Bill Gates has been quite clear that “we don’t want lots of recovered COVID-19 patients”
      (as they would not then need the drugs and vaccines that Big Pharma is salivating to develop and sell.)

  5. BJ

    It will be interesting as we get the serological test online. Those that have antibodies get to work and get paid, those that don’t starve? I can’t imagine we will have any kind of sane reaction to this biurcation of our population.

    1. divadab

      NO I think you are leaving out the low-risk uninfected – the young. They can work. It’s only the at-risk population that needs to isolate. In the meantime, public cleanliness protocols are essential. It’s the lockdown of EVeRYONE regardless of risk category which to me seems excessive, at least for more than a month, maybe two.

      1. Yves Smith Post author

        This is utter nonsense. The models show it. We’ve discussed it in the post and elsewhere.

        You are spewing disinformation and confirming you did not read the post in full. Both are a violations of site Policies.

        You need to stop commenting on this topic. You remarks are negative value added.

      2. rd

        Our county executive has posted the hospitalization figures for the county (about 400 cases overall, so reasonable statistical sample). Most of the people hospitalized are actually under the age of 60, many under 40.

        The highest risk of death by far is in the over 70 group, but it is clear that people from their teens to middle age can get seriously ill and can end up with serious permanent damage if they don’t die.

        It is a myth that it is “low risk” for people in their 20s and 30s – it is still far worse than the seasonal flu for them. In addition, they go home etc. and can infect other people.

        1. Michael

          Our experience here in San Diego also.
          All groups (20-30, 30-40, 40-50, & 50-60) have more reported cases than the two older groups.
          Men and women are now near 50-50 where in the beginning men were 4-1.
          We also had 12 deaths reported last night taking the total from 19 o 31.

          “”The age range of the new deaths is between 23 and 100 years. Eight were women and four were men. The deaths occurred between April 3 and April 6, 2020 and all the people who died had underlying medical conditions.””

    2. Code Name D

      But where will these antibody tests come from, and how will they be paid for? The pandemic is bad enough. But the US healthcare system is DESIGNED to frustrate any attempts at public health, focusing exclusively on commodification. How wide spread are these antibody tests if its going to cost the patent $2000 a pop.

      One fear I have is that Covid adds to the wealth gap. Where those who have the money to get tested, or can afford the vaccine and regular booster shots, get to go to work and go out to socialize. While those who do not face a permanent qusi-quarantine. They can’t work, they can’t go out and socialize, their kids can’t go to school.

      And what if they are black or other ethnic minority? What a great way to reinstate apartheid.

      1. Fiery Hunt

        Stanford is trying to do exactly these kinds of tests. Trying out the hypothesis that the virus started much earlier than current assumptions and that California had exposure much sooner and has built up some herd immunity (for what that’s worth..see Yves’ comment on the common cold). Hard to explain the difference in CA vs. NY thru just social distancing and density…particularly given the higher exposure to China travelers early on.

        That said, my personal experience was there was a nasty lingering cough/bug going around the Bay Area in early Nov.—I had it for 8 weeks in Dec. Have half suspected it was Covid-19…

        The Standford tests…

        1. periol

          “Hard to explain the difference in CA vs. NY thru just social distancing and density…particularly given the higher exposure to China travelers early on. “

          I think when you add CA’s abysmal testing numbers in, you can probably sew up the whole picture. The state shut down first (not early enough, but still), is less dense with less pedestrian mixing, and is still nearly last in per-capita testing in the USA.

          The coronavirus is spreading, is most likely much worse than official figures (including death numbers), but the measures and suburban nature (especially LA & SD metro areas) are helping it from spreading as fast and lethally as it is in NY.

        2. Nick Alcock

          Indications from the virus’s genetics are that SARS-CoV-2 originated no earlier than October. No cases were observed before December, all in Wuhan. It is *most* unlikely that it had jumped continents by early November!

          What we did have then was a nasty seasonal flu (it laid me out for two weeks in early Dec).

    3. ZacP

      It is important to note that an antibody test can mean different things depending on the specific infection. For example, a person who tests positive for the HIV antibody still also is a carrier of the virus and can infect other people. It can also take months, as many as six, for antibodies to become detectable via the standard labwork.

      Combine that with false +/- results, length of time to ramp up production of testing kits, and we still need evidence to be able to interpret what a +antibody result would even mean in the case of COVID19…….serum testing still seems to be a long, long way out from actually being able to guide decision making.

  6. Larry

    The desire in the west to not ramp up a war like posture is disheartening. Debt jubilees and massive unemployment support for employees and small business owners is what we need. Massive WPA style employment programs is what we need coming out the other side. Instead we’ll get more inequality and service to capital. This will further disintegrate what little is left of our society.

    I’m hopeful that some of the actions I’m seeing anecdotes about like rent strikes and work strikes can reverse this terrible tide of the economy mattering more than people’s lives.

    1. Nick

      They are already backpedaling on even the smallest EIDL loan. It is the $10,000 advance “grant” for businesses with under 50 employees. It included sole proprietorships with zero employees as well. It was the easiest loan to sign up for during the terrible rollout of the bailout CARES act for the small businesses. Now, it makes no mention of single owned, no employee sole proprietors and just says $1,000 per employee up to 10 employees. Then the forgivable amount went from $200,000 to $15,000. If we pull out of this and don’t end up in a “Postman” like societal collapse, my choice of vision for the “new society”, NOBODY should go back to work until all the dollars are in the right places.

  7. Ignacio

    Yep though some re-opening will occur if we don’t want to sink much more than what that graphic anticipates and it will require cooperation at all levels: citizenship, municipal, state, nation, international… and we look very far from that given that incompetence seems well established also at all levels. For what I know about it in Spain, I have some observations from friends implicated in the development of epidemic surveillance services (from apps to testing), though we are racing against the clock there are lots of coordination problems and experts seem unable to reach a consensus (damn!) as if experts in different areas are competing instead of collaborating to reach some kind of sub-optimal consensus. This is depressing. At EU level the failure is systemic and the President of the Eur. Res. Council has resigned.

    I think that German authorities, as well as their counsellors are being too overconfident on what Wolf calls their “risk-adapted strategy”, and I can just cannot stop short of saying they are being wildly idiotic if at the same time no EU-level cooperation is allowed and they believe this is just a state matter. We will see but as an export led economy they have a lot to loose and the graphic above says it all.

    1. Bsoder

      I think the Germans in their statement of “risk adapted strategy”, in combination with everything else they have done – closed their borders, and not done refused to give or loan a dime to either Spain and Italy, but blocking every EU proposal to do, allows for the inference, that they believe not too many Germans are going to die during before a vaccine is created. Pennywise, pound foolish.

      1. Petter

        My son lives in southern Sweden and teaches Crossfit once a week. The class enrollment was thirty but is now down to about fifteen. I called him now and asked if the class is keeping social distancing. He said that they’ve been advised to keep a two meter distance but they’re not doing it.
        The death toll in Sweden is now 687, up 96 from yesterday. 8419 infected as of today, up from 7206 yesterday.
        I’m skeptical about this native social distancing hypothesis.

        1. Ignacio

          Skeptical? Just pray not a cluster reaches this group. That would be more practical. Have you ever been in New York, London or Madrid (for instance)? You would be astonished to find hundreds or thousands of Restaurants, Cafes and streets packed with people like tined sardines. Nothing you can find in Ystad or Malmö, for sure.

          1. Petter

            I am skeptical that this native social distancing hypothesis will keep the infection rate down, if that is in fact what is being argued.
            As for crowds and restaurants and people in extreme close proximity, Malmö, and the Lilla torg area on a weekend evening, is as tightly packed as anything I’ve seen in the two aforementioned cities. BYW, Ystad has a terrific hotel spa – it’s open.

            1. Ignacio

              OK, Sorry I misunderstood you. Regarding the Spa, I wouldn’t go there these days except if I am alone. 1 by 1 but I guess this would be very expensive either for the hotel or for the guests.

        2. Clark

          As a former Crossfitter, this is shocking in a way. Even if the class was keeping two meters apart at all times and diligently wiping down the equipment, that would not solve the airborne problem. I am guessing that in a Crossfit gym during and after the workouts the aerosols would be very infectious even if just one person was asymptomatic. Attending any type of group exercise does not seem wise, to put it charitably.

        3. Tom Bradford

          Sweden has 2x New Zealand’s population. As of yesterday NZ had 969 confirmed cases, 241 probable and 1 death, with testing still ramping up and new infections declining. And is in full lock-down.

          I know where I’d put my money.

      2. rd

        Kind of like Nebraska – their numbers have been fairly good all along without taking a lot of measures. But quite rural without a lot of socialization.

      3. Anon

        Their is a wonderful radio conversation between “The World” host and the leading public health officer in Sweden. About two weeks ago the office holder dismissed the hosts questions about the lack of concern over Covid-19 in Sweden. His disdain and dismissal was precocius, in the least. When Sweden, pop. 9 million, topped 500 Covid-19 deaths that disdain and dismissal disappeared.

        There are still some public health officials in the US that ascribe to the “social distancing” could kill more people than the virus meme. My county health officer did so at today’s Board of Supervisor’s meeting—fortunately the disbelief by the Supe’s was palpable.

    1. PlutoniumKun

      Even looking at the raw, crude ‘current’ figures on the current JHU map, Sweden has a vastly disproportionate death rate from Covid compared to its immediate neighbours, by a rough calculation I’d say 3-5 times as high as Norway/Denmark/Finland, whether you count by ‘% of confirmed cases’ or ‘% of population’. There is something very bad going on there, and it’s only just getting started.

        1. Jesper

          It will probably take years before it is known why Sweden differs so much from the other Nordics, there are a couple of theories floating around. One relates to the fact that almost one in five in Sweden was born abroad, link below to the stat (19.6% born abroad), and might not have received and/or understood the official warnings and recommendations as communicated by TV/Radio etc. A total lockdown might have been easier to communicate.

          The newly arrived tend to be poor and therefore living together moreso than the natives. The poorer areas of Stockholm appear to be worse affected than the rich:

          The official FAQ:

          It has been officially denied that Sweden is going for the ‘herd-immunity’ strategy. However, the measures taken appear (to my untrained eye) to be very similar to going for ‘herd-immunity’. & while asymptomatic contagion might be rare it seems that Sweden might maybe possibly have estimated that the risk of asymptomatic contagion to be lower than what other countries has estimated it to be. Time will tell.

    2. td

      What keeps happening, over and over, is that jurisdictions that have relatively low numbers of cases and deaths are living in a dream enabled by a lack of comprehensive testing. Usually, the cases and deaths begin to grow exponentially and by the time the authorities react, the possibility for efficient containment has been lost.

      The death rate for this thing may be around 1% if the health services are not overrun, but if you can’t even give supplemental oxygen, they appear to rapidly rise to 6 to 8%. I fear for Africa.

  8. Bill Smith

    “But I have yet to see an expert opine that warmer weather will do all that much for contagion rates.”

    At least one study has been done. Warm weather will have a small effect. Maybe lowering R0 by 1/2 point. That is, if R0 is 2.5, it would be lowered to about 2.0.

    The study came from China and examined the rate of the growth in about 100 cities across the country.

      1. Tim

        Agreed, however, that might just be because most community transmission is likely occurring in indoor air conditioned close proximity scenarios.

        That doesn’t change the outlook for our summer, unless governments in the northern hemisphere consider a mandatory requirement that no gathering place be air conditioned below 80F. But without data, they won’t want to make people uncomfortable.

  9. Redlife2017

    The Archdruid (John Michael Greer) has a great way to look at issues and puts them in two categories:

    Problems: Issues that have a solution, i.e. problems can be solved.
    Predicament: Issues that must be managed, i.e. predicaments can’t be solved.

    This is obviously a predicament, where only looking for a solution will take up the time that you need to look for ways to properly manage what is happening. (Please note I’m not saying don’t look for a vaccine, I’m saying don’t make your plans for the next two years around that.) We always like to think that with enough elbow-grease / processing power, that there must be a solution, as per the myth of progress. But real life doesn’t work that way. The question we must ask is how do we manage this? And to stop acting like it is a failure if we can’t solve it.

    1. Yves Smith Post author

      Aha, that is a very useful framework. Wolf and many other sees this as a problem and I see this as a predicament. Wish I had been able to make that crisper in the post.

      1. David

        Yes, it’s something that people involved in disaster planning talk about. Essentially, the distinction is between problems that you can prevent or resolve; in whole or in part, problems that you can mitigate, in whole or in part, and problems you can effectively do nothing about. Like most crises, the current one is a mixture of all three, especially when you come to consider second and third order effects.

    2. Steve H.

      > And to stop acting like it is a failure if we can’t solve it.

      Kahneman: because we tend to reward others when they do well and punish them when they do badly, and because there is regression to the mean, it is part of the human condition that we are statistically punished for rewarding others and rewarded for punishing them.

  10. dcblotter

    the fact that Senators who were briefed on this reacted not by proposing legislation to insure protective gear for medical personal and other measures designed to protect their constituents, they dumped stock is a measure of the moral depravity of our political elite.

    1. rd

      Undocumented workers getting papers so they can go to work picking fruits and vegetables as “essential workers” at the same time Congress is on hiatus is telling…..

      1. Ian Ollmann

        Those are some unsung heroes that deserve recognition, and very likely citizenship, if they want it.

  11. marcyincny

    Thank you Yves.

    I’m picking/choosing my posts these days but this is a must read in my book.

    I didn’t read all the comments but elsewhere I’m seeing the word ‘endemic’ used more frequently and that to me means no ‘normal’ by anyone’s definition.

  12. Tim

    The best path of management of this crisis is clear to me. We need a massive public works project, employing everybody that is laid off as a result of the crisis.

    Their job will be administering widespread universal testing, documenting contact tracing and enforcing specific quarantines resulting from results of testing and contact tracing. This will enable the rest of our society to get back to living.

    The only way this get’s done is if the test providers and software database creators have a relationship to certain legislators to push for it. Otherwise there is no money to get the attention of congress and incentivize them to implement this.

    Surely we could have something worthwhile in place before the fall, or am I still being too optimistic?

  13. Henry Moon Pie

    It makes me very happy to see you addressing this so effectively, Yves. Many of our elites are very deep into denial and refuse to see how fundamentally this virus is changing us and our world.

    All the points made by your post and the comments about the essential needs that are not being discussed are valid and important. As you note, we must also figure out how to provide those needs without the providers or the recipients getting sick. That will be a major challenge, and all the silly talk about “back to normal” is just delaying getting down to the real issues.

    The elites, who seem to always respond with “hoocoodanode?” to the many disasters that have hit us in the past 20 years, need to start thinking about the future instead of delusionally obsessed with returning to the old world. They’re only making things worse over the next year if they don’t.

  14. The Rev Kev

    ‘Readers might come up with other examples of important infrastructure or systems that would have trouble functioning well if a site or sites were to suffer a coronavirus outbreak.’

    I did hear a few weeks ago how one power plant was going to encourage their employees to live on site but did not follow it up to see if they did so. I thought that I might add some surmises on the situation on Australia to see if it adds to the conversation. We are slowly flattening the curve here and have had only about 51 deaths. You would think that over time that we could wipe it out here as nobody can come into Austraia without two weeks quarantine. However-

    I have noticed several stories lately that seem odd. There are 500 million masks on order with China. Senior nurses are going out into the field before they finish their training. Medical stores are being built up. Stuff like this. My own interpretation then is that Scotty from Marketing is going to relax the lockdown in stages after six months and let the Coronavirus have mini flare-ups which explains the massive amounts of medical gear being readied. Why would he do that? Because he reckons that the cost of fighting this virus is to high for the economy and he wants to start it up again. For him, it is all about the economy so he is going for a slow motion herd immunity.

    It is the mushroom approach here. He has been promising for weeks to release the modelling that the government is using to decide how to handle the outbreak. But this week, he released overseas modeling and said that there was no local ones. He then said that when a model is developed, that after being reviewed by the Cabinet, that it would be released to the public. Probably under the 30-year Cabinet rule so that we will see it alright – in the year 2050!

  15. David

    I think that your point about “our old way of living will never fully come back.” simply hasn’t been internalized by most of the people who are busy sounding off about The Day After and after. No matter how evil and determined the system is, it can’t reinstate things that have been broken beyond repair. Take just one example: international travel. That’s likely to be restricted to certain regions for the foreseeable future, with nationals of any country where the disease is still suspected prevented from traveling, and no flights to those countries. You may have to show a constantly updated smart card or something even to be let on a plane. Millions of people working abroad may find they are stranded there. The international conference industry is effectively dead, many hotels will close, governments and multinationals will think hard before they send people abroad because of what they might bring back. The mass tourist market is surely dead, and many airports will close. Cities (including those in the West) that depend on tourism will be in deep trouble. The only way any of this can be avoided is if we can be completely sure that the virus has been eliminated from every country on earth.
    As I said, this is only one area, and a few very simple projections. It might be worth thinking about some of the others.

    1. Jen

      I told my boss this morning that we have to let go of the idea of getting back to where we are, and start figuring out how we’re going to manage based on the reality that is in front of us. Thus far, the number of cases in our little corner of the world is holding steady, notwithstanding the looming specter of the eventual return of 4000 contagion vectors, excuse me, undergrads. Which is akin to the old saw: “aside from that Mrs. Lincoln, how was the play?”

      All of our lab based research is on hold. Can we come up with protocols and infection control standards that might allow things to resume, at some point, in some fashion? Some of our people already work with prions and other gnarly things, so it’s not as though, institutionally, we have no experience with preventing exposure to things one should not be exposed to. But we would have to think very differently about how we approach the work that absolutely has to occur on campus, not just “we’ll do what we were doing, just with social distancing.”

    2. Clive

      Yes, definitely. As a worked example, in my own industry it’s starting to become apparent that for travel insurance, there is going to be a ground-up reevaluating of underwriting. Government is very miffed at having gap year students launching themselves off to places like Peru (the more remote and hazardous, the better the “experience” and Instagram photos) but then, having not taken out (already pricey) disruption insurance, when it all goes horribly wrong, there they all are (and “worried parents”, too, obviously, compete with tear-stained mascara faces) taking to Skype and saying isn’t it terribleness personified, why won’t the (U.K. here) government Do Something.

      It’s almost certain the government will stop being the completely unfunded repatriator of last resort. They will moot mandatory travel insurance including full disruption cover plus a service provider who will have high-availability passenger air transport on permanent standby. The cost will be crushing (easily $200-300 for single trip standard cover in low risk Europe, nudging $400 for big liability risks like the US and you’re probably looking at getting on for a grand for somewhere like undeveloped Africa or Central America for a three-month extended stay). Some destinations will also be regarded as uninsurable.

      You simply won’t be allowed to board your flight without your insurance certificate. To make the cost even slightly bearable for popular destinations like Florida or the Caribbean, the big tour operators and resorts will have to, potentially, buy local hospitals (or hospital capacity) or add hospital wings to their resorts lest they get price gouged by the local health systems. And be prepared to pay local airspace controllers to create emergency paths. It’s hard to think of a bigger re-engineering of an entire business model.

      1. Jen

        Our institution has worked out that in order to achieve appropriate distancing, and quarantine capacity, the can accommodate approximately 1000 out of 4000 undergrads who are typically in residence. This means 1 student per dorm room; not sure they’ve even attempted to work out the classroom spaces. It also implies some pretty optimistic assumptions about human behavior. We don’t have the capacity in our health care system to manage a wide-spread outbreak.

        What’s an ivy league education without an on campus experience? How many people will look at the price tag and decide on-line education is on-line education?

  16. SteveW

    The four requirements are essential. Had we (Canadian here) been able and willing to do that in January the way Taiwan did, we might not have needed the lockdown. Also, in Taiwan masks are essential and they place plastic separators to isolate the eating space. Taiwan still does not need to lockdown despite being next to mainland China with extensive links to it. Only a few hundred cases so far. Extreme diligent tracing and face masks have been the key to its success. Our about face on masks is the government’s paving the way to “opening the economy” . They will make it mandatory for transit riders and crowded places. Good luck if we do not attain the four requirements.

  17. TedHunter

    Analysis is only as good as the data it is based on. Our current data is a joke, but there is hope.

    There are two extremely important baseline studies going on. One in Germany (ongoing), the more advanced one in Italy. Details here and here. And there is, of course, the rather interesting statistical population on the Diamond Princess.

    We only start to understand rates of infection, patterns of infection, rates of disease, mortality.

  18. Susan the other

    When our TINA political class abdicated governing to the market they could have seen this coming. Anyone could have. We have political malfeasance going back all the way to Reagan. Now even the Fed is more responsible than the “government.” What we all need, on both a federal and state level is an organized procurement office which is coordinated with every other state. The federal government seems to have completely lost its instinct for provisioning. What has happened to the front-liners – going without PPE and sleep – is inexcusable. We need a constitutional amendment stating our obligations as a society to each other in times of pandemic or catastrophe and punishment for asinine-ideology-blabber from moronic neoliberals – they should be fined. And make them all do community service for 24 h ours straight.

  19. chuck roast

    The young Doc in the Lennox Hill video mentioned “chemical warfare.” If he is correct, then we are engaging in a civil war with an unseen enemy and this masquerading as a public health emergency. In which case Martin Wolf joins the ranks of the “learned nothing and forgotten nothing” contingent.

    I didn’t sit up and take notice until alerted by NC in early March that CV rapidly deteriorates into pneumonia. This closely followed by the Italian twit video of the fellow turning the pages of the local paper obits for the day and the obits for the same day a year earlier. You didn’t need to understand the lovely language to get the grim message.

    Maybe it’s time to start listening to the chemical warfare experts (sic). Let them participate in the conversation and relegate the business and economic Cassandras to the back of the classroom. We can begin listening to them again when we are without a new case for 14 days. But who knows when that will be? My local hospital informs the local newspaper that it does not divulge the number of CV deaths. It sends that info to the state department of health. CV deaths here are apparently a state secret.

  20. sam

    Reading through the comments this seems a more heated and personal debate than usual, which is understandable but not helpful. There’s an undeniable tradeoff here between mortality risk and economic risk. Mortality risk is greatest for (but not limited to) the old and chronically ill but economic risk is greatest for (but not limited to) the young, as evidenced by studies showing that economic downturns cause permanent damage to work skills and employment prospects. Finding a balance is fundamentally a political issue of balancing competing interests to which there is no black or white, right or wrong answer.

    1. Massinissa

      Even many of the NC commenters seemingly don’t want to believe the premise of the post, which is that things aren’t going back to normal anytime soon.

      If this is a problem even for normally rather erudite NC commenters, the chances of the mainstream population coming to emotional terms with the fact that their lives have changed irrevocably from this event anytime soon seems slim. On the other hand, such understanding may only put the mainstream population into complete and total panic as they rush to short term solutions or proffered strongmen with said solutions. Any kind of food shock will greatly exacerbate this effect. The next year or two will probably not be pretty.

    2. Painted Shut

      I agree. I think folks comments are reflective of their position in life and the risks inherent to that position. There will probably not be a 100% return to the “old normal”, but as Trump indicated, the country must re-open.

      The balance is this – Trump needs to re-open the country on May 1st. The scope creep is enough already. First it was 15 Days to Slow the Spread, then it’s 30 more Days to Flatten the Curve. Need to call it “mission accomplished” and move forward. We cannot wait until it’s completely eradicated, nor pervasive testing/contact tracing, nor a vaccine is ready. Wear masks, keep social distancing and washing hands, etc., but re-open the country. And most importantly, shift the mindset from “asymptomatic spreader shaming” to one of personal responsibility. In other words, give everyone back their ability to make choices.

      Keep in mind that we’ve been severely unfair to a preponderance of the population already, just in different ways. When we deemed certain folks “essential” and make them report to work everyday, what we’ve really said is “we need what you produce” not “you as a human being are important”. We’ve actually put them at greater risk of contracting the virus. On the other hand, they’ve been able to collect a paycheck. We’ve told others to stay home, valuing their health as human beings, but not giving them a choice as to their financial security/future.

      Also, what you deem essential given your circumstances (doctors appts, grocery store visits, etc) may differ from what I deem essential given mine (earning a paycheck to feed my family). Your 92 year old mother’s doctors appts are no more essential than my need to earn a paycheck, nor are my needs necessarily more essential than hers. So both of us need to be able to make those choices.

      It is time to allow folks to be able to assess the risk and make the best decision for them and their families. If that means go to work so my kids don’t starve or end up on the streets, then allow folks to make that choice. If it means choosing to stay home, but maybe end up getting laid off, then allow folks to make that choice as well.

      And if I get the virus, at that point I would have no-one to blame but myself. It takes two to tango. Sure, the virus carrier was there when I got it, but also, I was there too. Stop telling everyone else to stay home. If you don’t want to get it, YOU choose to stay home.

      1. eg

        What do you anticipate your position implies for the medical system? Because I’m thinking it would be an unmitigated disaster.

        So I hope you live far away from me and that you and those who think like you are utterly and completely without influence over either my public health officials or politicians.

        1. wilroncanada

          It’s just a death wish. The man needs to feed his children, or kill them off when he brings the disease home, or they bring it home because they go out too, following his example.

          1. Painted Shut

            Have you stayed at home this entire time? Bet not. Bet you went somewhere, and probably more than once. Did you know that the coronavirus doesn’t care whether or not your trip was something you deemed essential?

            Did you know that there are people who have gone to work every day despite the lockdown? Essential occupations? Do they have a death wish? Are they bad examples to their children? Is it fair that we put some folks in harms way healthwise while others get to stay home? Is it fair that we’ve put some folks in harms way financially and protected others? Your ad hominem implies that you are good with it. Guessing you are boomer age with little concern financially.

            22 days from now, is it not reasonable to maybe introduce personal responsibility and choice into the matter?

    3. Ian Ollmann

      A lot of it is fear, no doubt. I’m afraid too, but not on a financial level. I just don’t want to get sick. For me, I still go to work, but the commute is to my home office. I get to spend all day with my four favorite people in the whole world, wife and children. There is extra cat time. I have my own quiet office with view of the redwoods rather than the crowded and noisy one at work. Risk of car accident is near zero. I’m not eating out anymore, which I expect is better for my health. All and all, life in the walled garden is pretty good! Between that and the environmental dividend, I should be saying, “I for one welcome our new viral overlords!”

      The problem here is that this is a tale of two cities, and for my bit of luck, there are dozens of others for whom the shutdown has been a disaster. I gave my electrician time and half for the last job. I should have gone double, but I wasn’t sure he’d accept it. Alas, this is a bandaid. What we really need is a change in economic organization to stop kicking people so hard for not working. At least for the moment, we don’t want them to work if we don’t need the work. Staying at home and attending the kids or dog or reading or whatever should be just fine. If we could put all of these nonessential workers back to work on a green new deal, I’d be tickled pink! We should not forget our other problems in a rush to return to normalcy.

  21. Jeremy Grimm

    The Government and public health authorities in the U.S. have left me with less reason to have faith in them than the little faith I held before the Covid pandemic. I intend to do everything I can to convince my daughter to remain holed up in her apartment in Brooklyn [I hope she has been!!!!!] for as long as I can after the government announces: “All is well everybody go back to work”. One ‘positive’ I can hold on to — I doubt employments my daughter held — before Covid — as a bartender or before that as a waitress or before that a barista will return sufficiently to absorb all the unemployed bartenders, waitresses, and baristas in the City. With some sacrifice I could keep her rent paid-up assuming her roommate can continue paying rent too. I wish I could convince her to move out of the City to some smaller community far from an area with a large concentration of people.

  22. ewmayer

    Hey, stawk markets are feeling all bubbly once again, so who cares how the pandemic affects actual people and the real economy? With those $1200 stimulus checks, peeps can buy, like, 2 shares of TSLA, with its lowest-in-the-industry P/E ratio – ‘lowest’ because its P/E is negative, as in “we lose money on every car we sell but make it up on volume”. A total historic steal of a sale price these days, get yer shares before the Wall Street gamblers-with-Fed-money realize it and push the price over $1000 per share.

    1. Ian Ollmann

      When companies start to go under, they will change their tune.
      P/E is still sky high, and probably will go higher (in a bad way) before the end.

  23. Bob Richard

    The economic impact of “lockdowns” and “flattening the curve” depends heavily on something that has only been alluded to so far in this thread. That’s the extent to which we test everyone with symptoms, isolate everyone who tests positive, and trace all of their contacts. That is how you defeat an epidemic. Shelter in place buys necessary time — at great cost to the economy — but without test, isolate and trace that’s all it does. This is Public Health 101.

    To the best of my knowledge, the U.S. is just as far behind on test, isolate and trace as it is on PPE and hospital beds. As a result, the economic impact will be even larger than it could have been.

    1. Jeremy Grimm

      Don’t you mean test a large unbiased sample of everyone with or without ‘symptoms’ — whatever those symptoms are supposed to be. Many people who have and are spreading COVID-19 do no show symptoms.

      1. Bob Richard

        Testing the general population might be even better. But not at the expense of diverting resources from testing everyone who is found, through tracing of contacts, to potentially have been exposed. In the U.S. there aren’t even enough kits to test everyone with symptoms, much less this larger group.

        1. periol

          If only the CDC hadn’t thoroughly screwed up with their million tests.

          Contact tracing needed to go in place in February, March 1 at the latest – when we should have had the testing capacity to put contact tracing and thorough testing in place. We lost the war with coronavirus before the gov even admitted it had started here in the USA.

  24. VietnamVet

    This post is quite right. The West devolved into a grand scheme to increase profits for a few at the expense of everyone else. The bill has come due. Digital Money will be spread through Wall Street. But it is not nearly enough.

    Online shopping and delivery companies made sheltering in place possible to date for 75% of Americans. For the poor this is impossible. This is why the NYC hotspot is severely impacting Blacks and Latinos. Every screw-up so far indicates that the federal government has yet to see past May. Real money will have to be spent for months if not years to keep Americans alive and prevent unrest. Hospitals must not close, doctors and staff must be compensated and protected, utilities kept functioning, people supplied with medicines and food. Amazon is given up on its delivery service. The Post Office is fraying at the edges. COVID-19 patients are filling up for-profit hospital beds. Who will pay the $11,000 per day ICU per patient costs – the government or the poor & middle class Americans? Who will protect the people from the predation of the few remaining vampire monopolies?

    To reopen service and manufacturing industries, there must be a universal public health testing program that monitors the coronavirus status of every worker, tracks and quarantines all virus shredders at home or in a safe facility. Only government can do this.

    This is the tragedy of the Biden Trump 2020 campaign. Like the Wuhan epidemic in January and February, the consequences of the coronavirus pandemic for Americans is being ignored until it is too late. The excess deaths are on them.

  25. ShamanicFallout

    I thought I would add this from my personal situation. I have a wholesale food business, mainly supplying thru mid-size food distribution to grocery, and thru the internet via the usual suspects. What’s happening here is that most of us- suppliers, distributors, sellers, cannot keep up right now with the demand. There is a huge shift happening right now (maybe this won’t last over a long period, idk?). This goes all the way thru the supply chain obviously. I talked to a small specialty internet seller today who had gone from 20 to 30 orders a week to 600! And there is no possible way for them to meet that demand. We are in the same situation. Even the distributors I know are completely in the weeds right now.
    This is a major change in how people get their food, where they buy it and how it gets to them. Perhaps it just the fallout from ‘panic buying’, but even if we could scale up, the immediate cost of doing that is not possible. Same for all the businesses we deal with, on the back end and on the front.
    And also, as was alluded to above, some people are able/ lucky to ‘work from home’. I am not. I sometimes wonder if people really know where and how their food gets to them. I doesn’t just appear on a shelf or on their doorstep in a box. I think everyone here has a good idea of what it takes to make that happen, but I think most people actually don’t.
    Anyway, not sure where this is headed from this perspective. I think at some point the supply chain will ‘catch up’ but things are probably going to look a lot different.

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