Paul Romer Comes Out Against Contact Tracing in the United States (which Biden Supports)

By Lambert Strether of Corrente.

I had been intending to write a post on lesser-evilism, but then I saw the tweet storm from Paul Romer that follows, and I thought I should but it before you immediately. (However, if we have any philosphers or theologians in the readership who are familiar with the problem of evil, especially institutional evil, I’d love to hear them.) Paul Romer is an economist that NC can actually appreicate; hard to believe, I know, especiallly because Romer won a “Nobel,” and was formerly chief economist at the World Bank. Nevertheless, Romer (with co-author George Akerlof, here, here, and here) wrote the paper (“Looting: The Economic Underworld of Bankruptcy for Profit“) that Yves calls “seminal’ to understanding “who wins no matter what” in our “current hypertrophied financial system.” Bill Black discusses Romer’s demolition of mainstream macro here (while noting that Romer is not on the left; far from it.) So there’s a lot to like about an economist who elucidated accounting control fraud (a form of looting) well before the Crash and the foreclosure crisis.

Romer takes the strong-form position that “contact tracing will not work in the US“[1]. Jerri-Lynn writes:

Well-done contact tracing has been an effective policy, deployed by some Asian countries which still enjoy admirable infection rates. In some cases, these model countries never implemented full lockdowns. Yet countries that have adopted the neoliberal playbook have demonstrated their inability to do contact tracing effectively, largely because they cannot figure out a way to monetise the process (see here for a representative criticism, among the multiple posts I have written on the topic).[2]

And so to Romer’s tweet-storm. First, given the failure of contact tracing in the United States, he poses two alternatives:

This post will not consider alternative (ii), nor does Romer. Of alternative (i) — where I am irresistably reminded of the liberal Democrat tendency to double down — Romer poses two more alternatives:

Once again, we will not consider QN of fact 1; only QN of fact 2. There, the answer is a resounding “No!”

Here, readers will no doubt remember our own John Siman’s interview with Thomas Frank, “Democracy Scares, from the Destruction of Bryan to the Abdication of Bernie: Why America Desperately Needs a Second Populist Movement but Ain’t Gonna Get One an interview + Review of The People, No! A Brief History of Anti-Populism by Thomas Frank“:

And no one alive writes about the American meritocracy with more insight than does Thomas Frank. His summary of their ways is worthy of memorization: “For them, merit is always synonymous with orthodoxy: the best and the brightest are, in their [own] minds, always those who went to Harvard, who got the big foundation grant, whose books are featured on NPR” (Listen, Liberal, p. 39). These are the men and women who, for going on seven decades now, have formed the Professional Class, the Expert Class, the Liberal Class, the Creative Class, the Learning Class, the Opinion Class, and so on and so forth — they are, in short, the hipper, cooler (and now woker) half of the American Ruling Class. Bottom line: Not only are they way richer and more powerful than you, they are way better than you, both intellectually and morally. At least they see it that way.

Most non-elite Americans, however, because they have, at this point in our history, endured over two generations of breathtakingly spectacular meritocratic failures — including the unending trillion-dollar wars that the elites never fight in and never win, including the elites’ financialized ransacking of the once-industrial American heartland, including the elites’ perversion of medical care and higher education into grotesque unaffordable rackets — would, if asked, give a more precise answer to the intriguing question of class nomenclature — Liberal Class? Creative Class? Learning Class? — by describing the ascendant meritocracy as our gleefully parasitic Fuck-Up Class.

So, “the public’s” rebellion is not without reason. You can come up with your own evidence, I am sure, but here is Romer:

The question becomes, can the “experts” admit that their expertise does not provide ethos, but in fact may destroy it?

(This would require self-reflection and the admission of possible failure. Our Professional Managerial Class has a low EQ in both.) Here again, we are reminded of Frank. From “Thomas Frank: Liberal Elites Will Create Conditions for Another Trump“:

I keep coming back to the same theme, which is that experts tell us, you know, the sort of people who call themselves experts, the professional class, let’s put it that way, people with advanced degrees who basically make the world that you and I live in. They are the ones who make our laws, who design our buildings, who set up our corporations, the people that Richard Hofstadter thought he was writing a manifesto for, this class of people presents themselves to us as neutral, disinterested experts. They will make the right decision on our behalf.

And what I have said again and again and again is that like any other social cohort, these people will act in their own self-interest and they will help each other out, and they will help themselves when the chips are down. And you saw that in the financial crisis, in the most extraordinary way, where one set of elites bailed out another set of elites and there was zero accountability. There is zero accountability for these people who had crashed the global economy. None of them got “canceled”. They’re all still there, they still have theIr goddamn jobs. It’s the most amazing thing.

My message is that these people act as a class, think as a class, and they’re doing it. They’re manifestly doing it in a way that is so patently obvious right now. Anyhow, that’s my joyous message under the world.

And back to Romer:

(I hope so too, for the same reason I hope that Operation Warp Speed produces a safe and effective vaccine or treatment; the country faces ruin otherwise.) And speaking of expert kamikaze missions, from the New England Journal of Medicine, “Ensuring Uptake of Vaccines against SARS-CoV-2“:

One option for increasing vaccine uptake is to require it. Mandatory vaccination has proven effective in ensuring high childhood immunization rates in many high-income countries. However, except for influenza vaccination of health care workers, mandates have not been widely used for adults.

We believe that six substantive criteria should be met before a state imposes a SARS-CoV-2 vaccine mandate[3]

“Substantive” is doing a lot of work, there, but one thing it is not — hold onto your hats, here, folks — is democratic. Here they are; I’ve helpfully annotated them [thus]:

1. Covid-19 is not adequately[A] contained in the state.

2. The Advisory Committee on Immunization Practices[B] has recommended vaccination for the groups for which a mandate is being considered.

3. The supply of vaccine is sufficient to cover the population groups for which a mandate is being considered.

4. Available evidence about the safety and efficacy of the vaccine has been transparently communicated[C].

5. The state has created infrastructure to provide access to vaccination without financial or logistic barriers, compensation to workers who have adverse effects from a required vaccine, and real-time surveillance of vaccine side effects.

6. In a time-limited evaluation, voluntary uptake of the vaccine among high-priority groups has fallen short of the level required[D] to prevent epidemic spread.

NOTES [A] As decided by whom? [B] A “magic board”! [C] So “transparency,” as opposed to acceptance, is all that’s required? [D] As decided by whom?

To be fair, I should give credit to the NEJM for not trying to screw over the workers too hard — paid leave for the vaccination? — but this is simply not a democratic process. It’s also not a national mandate, so it’s not clear to me how the NEJM proposal will work in a Federal system. What about non-vaccinated “hot states”? Will there be internal passport?

It remains only to look at what the Biden campaign proposes. Does Biden propose contact tracing? Yes. From “The Biden Plan for an Effective Re-Opening That Jumpstarts the Economy“:

Build a National Contact Tracing Workforce: Once COVID-19 infected people are identified, we need to find those to whom they might have unwittingly spread the disease. Contact tracing is a core component of a robust nationwide data-driven disease surveillance system. Given the massive unemployment problem that Trump generated and the incredible need for contact tracers, Biden would:

Create a U.S. Public Health Jobs Corps. Through this Corps, the federal government will closely coordinate with state, tribal, and local leaders, as well as unions, to mobilize at least 100,000 people — and many more, if necessary — to support the public health response including by ensuring contract tracing reaches every community in America. Corps members should come from the communities they serve in order to ensure that they create trust and are as effective as possible.

(I have no idea if 100,000 is enough. I doubt it.) Does Biden propose to emphasize exhortation by experts? Yes. From “The Biden Plan to Combat Coronavirus (Covid-19) and Prepare for Future Global Health Threats”:

Biden knows how to mount an effective crisis response and elevate the voices of scientists, public health experts, and first responders.

Biden believes we must immediately put scientists and public health leaders front and center in communication with the American people in order to provide regular guidance and deliver timely public health updates, including by immediately establishing daily, expert-led press briefings.

If Romer is correct, the “horns effect” of exhortation by justifiably mistrusted experts will undercut the effectiveness of the National Contact Tracing Workforce (NCTW). We should, of course, all hope that Romer is wrong. We might also hope that the NCTW is so recruited and empowered that the contact tracers can win the trust of recalcitrant communities. We should also hope that Biden, FDR-like, can say that “It is common sense to take a method and try it. If it fails, admit it frankly and try another.” Sadly, our Professional Managerial Class is not known for that.

NOTES

[1] As a sidebar, Romer supports testing:

Atlas, of the Hoover Institution, supports “herd immunity,” which is pleasingly open, as opposed to Tory obfuscation. Herd immunity does not strike me as a good idea. See The Lancet, “Prevalence of SARS-CoV-2 antibodies in a large nationwide sample of patients on dialysis in the USA: a cross-sectional study” (notes omitted):

[W]e show that as patients receiving dialysis have monthly blood draws, without fail and without bias, and are a population with increased representation of racial and ethnic minorities, repeated cross-sectional analyses of seroprevalence within this sentinel population can be implemented as a practical and unbiased surveillance strategy in the USA.

And:

[O]ur findings comport with other seroprevalence estimates. We confirm that as in other studies from COVID-19 hotspots, a minority of the population has evidence of exposure and immune response, and a vast majority, including people at high risk for mortality (ie, the population on dialysis), remain vulnerable. In fact, even if the seroprevalence estimates derived from the US dialysis population overestimated true seroprevalence in the overall US adult population, our data nonetheless support that fewer than 10% of the US population has seroconverted as of July, 2020, and herd immunity remains out of reach, as has been the conclusion from large international surveys from the UK and Spain, where intense outbreaks of COVID-19 occurred during the spring and summer of 2020.

So, herd immunity is a pony. Too bad!

[2] It also seems likely that with respect to contact tracing the Covid horse is, by this time, in the next county. Yves writes in “Coronavirus Magical Thinking, US Style: Contact Tracing Versus Masks“:

[It’s way] too late for contract tracing to work. Joseph Norman, Yaneer Bar-Yam, and Nassim Nicholas Taleb pointed out in a January paper that contact tracing was ineffective once a disease reached pandemic scale:

Standard individual-scale policy approaches such as isolation, contact tracing and monitoring are rapidly (computationally) overwhelmed in the face of mass infection, and thus also cannot be relied upon to stop a pandemic. Multiscale population approaches including drastically pruning contact networks using collective boundaries and social behavior change, and community self-monitoring, are essential.

So while it’s true that contact tracing apps are genuinely silly (as J-LS points out) and old-fashioned “shoe-leather” methods are proven and effective (J-LS again), they both amount to closing the barn door.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

61 comments

  1. Glen

    Know why contact tracing FAILS in the US?

    So somebody walks up to you and says you need to take the FREE CV test. OK, but if I’ve got it, who pays my bills for the two weeks I have to spend at home? And who pays my hospital bill for treatment? Sorry but, reality is go {family blog} yourself and the {family blog} hole private healthcare insurance system you represent, I go to the hospital when I’m dying, not before.

    Just like all this nonsense debate that we need to “do a Sweden”. Uh, dude, Sweden has Medicare For All. Until we have that, I have no interest in doing a Sweden.

    Reply
    1. Fiery Hunt

      I’m definitely smelling what your cooking, Glen.
      There is no way, and I mean NO WAY, I ‘m being forced to take any shot, pill or any other “therapeutic” from this government…or the next.

      Always wanted to argue something before the Supreme Court… plenty of lawyers would love that one.

      Reply
      1. WobblyTelomeres

        Yeah, well, if 60% of the population is sufficiently brave (or apparently foolish in your analysis) to take a vaccine approved by the FDA, CDC, and NIH, then we can achieve herd immunity. And you will benefit.

        Despite Trump and Biden, there are a lot of very smart, very dedicated scientists in our government. I know several, people I trust enough that if they told me to jump off a bridge, off I’d go. I’m sorry you don’t have people like that in your life.

        Reply
        1. Carla

          TRUST. That’s what it’s all about, Wobbly.

          I’m a relatively privileged, relatively well-educated, relatively fortunate member of this “society.” Objectively speaking, I’ve got no ax to grind.

          And let me tell you, I TRUST my life partner, a few family members and close friends — and that’s it.

          At this point, I TRUST no institutions of government or civil society whatsoever. No “experts,” no “scientists,” no “leaders.”

          Once TRUST is gone, it takes a hell of a long-term effort to get it back. An effort that may never succeed.

          Reply
        2. Janie

          Like Carla, i trust many people in my life, but not one of them is an immunologist. Given the shortened trials, I’m waiting also. No, I’m not antivax; I’m old enough to remember polio epidemics.

          Reply
        3. Lambert Strether Post author

          > Despite Trump and Biden, there are a lot of very smart, very dedicated scientists in our government.

          Absolutely true. Science really is something that you can love and pursue for its own sake. Unfortunately, all the dominant tendencies in our society work against this.

          Reply
            1. Steve Ruis

              Actually not. It was just that politicians were not smart enough to understand the science per se and were cowed by the prospect of being wrong. The current administration is just a susceptible to not understand, but doesn’t give a flying fart about being wrong.

              So, scientists were allowed to lead … even when they were wrong. And one can make an argument that public science is run by granting agencies and they are not necessarily run by scientists.

              Reply
        4. Dwight

          Fiery Hunt didn’t say they wouldn’t take the vaccine, they said they wouldn’t be forced to take the vaccine. Fiery Hunt was also responding to Glen’s financial concerns, which are real for millions of people.

          FDA approval is key, as you say, but justified or not, there is suspicion of undue influence on FDA by corporations and Trump hasn’t helped. Even with an approved vaccine, there remains the question of compensation for vaccine injury as recognized by the NEJM article. That has been an imperfect system and the potential for it being overwhelmed is real if a vaccine is rushed to market.

          Reply
      2. Carolinian

        Me too. Let’s roll back the tape to the discussion here about vaccines and the revelation that vaccines will have passed their approval test if they are only fifty percent effective (although they hope to do much better). Which means that if everybody took the vaccine you would still have covid around. It would also mean that any vaccine “passport” would be meaningless as you could still pass on the disease even if vaccinated.

        Flu shots are offered every year as a way of giving people more protection and they have been around long enough for the public not to have much anxiety about side effects. Flu shots are not, however, offered as a way of “solving” the flu in the way that polio vaccinations eventually were. That being the case I suspect the polls are right that a large portion of Americans would not take the shot and that includes me.

        In my state the death rate has been down for several weeks now compared to the summer surge and there’s not much sign of that changing. Cases are up nationally but not deaths so far and this is in line with the prediction of some doctors who have said that we will have a second wave but that it will be less lethal. I’m certainly no expert on this and my opinion worth very little but here’s suggesting that the pandemic will do what others have done and simply go away. In any case I’m considerably more certain that Americans will not cooperate with any forced contact tracing or vaccine regime.

        Reply
        1. Mr grumpy

          Fatality rate is down only because the percentage of people under 40 being diagnosed is far higher now than it was in spring and early summer. Still quite deadly to older folks.

          Reply
          1. Carolinian

            Right. And perhaps many of those older folks and those with poor immune systems have sadly expired now. The likeliest victims are no longer around. Which is how epidemics work and why they die out.

            I know the consensus around here is to treat herd immunity as some kind of nutty idea but it’s the way humankind has proceeded over the past few millenia. Perhaps nations like Korea will be able to control the disease long enough to avoid a high casualty rate while the rest of the world develops herd immunity but that’s still the way it is going to work. Also there may be other reasons–a previous Sars epidemic–that make those Asian nations less vulnerable. Which is to say some groups may already have a stronger innate immunity to covid than others so comparisons, one nation to another, are not entirely what we think.

            Reply
            1. Carolinian

              Adding “quite deadly” needs to be defined. The CDC published the percentages a couple of weeks ago and even for seventy somethings the odds of survival, as we saw with Trump, are quite good. Most victims are in their 80s.

              Reply
            2. Lambert Strether Post author

              > I know the consensus around here is to treat herd immunity as some kind of nutty idea but it’s the way humankind has proceeded over the past few millenia.

              See footnote [2].

              Reply
  2. chuck roast

    In lieu of a few IPAs and a couple snaps of Aberlour, I have no pretensions towards philosophy. However, as a recovering Catholic, and being intimately familiar with how many angels populate the heads of pins, I can stake a claim to being a minor theologian. Jerri-Lynn’s little bon mot that:

    “…countries that have adopted the neoliberal playbook have demonstrated their inability to do contact tracing effectively, largely because they cannot figure out a way to monetise the process…” is clearly divinely inspired.

    Surely, the College of NC Cardinals can agree that the venial sins JL has accumulated will, on the appointed day, be entirely expunged. She shall shed her mortal sins along with her mortal coil and pass immediately to heaven without recourse to the purgatory that awaits the rest of us great unwashed. Dominus vobiscum.

    Reply
        1. Samuel Conner

          I’m inclined to think that she and Jesus were “on the same page”. Gehenna is a Greek transliteration of
          “gei hinnom”; “hinnom valley”, a real physical place below the walls of Jerusalem. Many dead bodies of inhabitants who perished during the AD70 siege were disposed of by tossing over the walls, and piled up there. The later chapters of Josephus’ “The Jewish War” discuss the siege at length. He claims that 1.1 million people perished in the city during a span of about 3 months, an unprecedented concentration of suffering in a small place.

          It was, indeed, “hell on earth”.

          The dysfunction of the leadership of the armed factions in the city feels reminiscent of current conditions.

          Perhaps US is facing its own version of gehenna, brought on by decades of its own bad leadership.

          Reply
    1. apleb

      ““…countries that have adopted the neoliberal playbook have demonstrated their inability to do contact tracing effectively,”
      As a fellow catholic, this line in the article is one which really grated on me.
      Yes, contact tracing has to be paid, it costs (a lot?) of money.

      However, there are tons of countries, ones that handle the pandemic mostly well and ones that don’t, which are all neoliberal to a more or less same degree.
      Sweden, South Korea, UK, China itself, Germany, France, Russia. All are neoliberal. No real exceptions with a widely different rate of success in containment.

      What often differs is the the health system and how well it works. You have to have the people capable and have the money to do contact tracing. Some countries simply rationalized away the people in former good times, maybe have no clue to train them again and especially have not the will to fund them right now. My guess is UK is like this now but I have no real knowledge about it, even when they have M4A which is touted as the panacea on this site for all ills. Which is simply idiotic imho, written from a country which started M4A 140 years ago.

      Reply
      1. Dwight

        UK does not have M4A. They have a National Health Service, public providers of health care. M4A is public insurance and, for the most part, private providers. Just wanted to clarify that.

        I agree that neoliberal countries can publicly fund health care and public health measures like contact tracing. Japan is another example. How well Japan would address a larger outbreak remains to be seen, but they’ve done well so far and the medical and public health system is a big part of that.

        Reply
  3. cat’s paw

    not convinced that institutional evil is a particularly helpful or coherent analytical concept here. very few us of still accept, tacitly or otherwise, the metaphysical commitments necessary for capital e evil to be instinctively cogent – which all great presuppositions need to be. it’s no longer an absolute moral force; just merely contingent, always localized in its effects, and routinely in dispute and subject to debate.

    probably do better re: institutions to follow nietzsche and speak of madness – “madness is rare in individuals, but in groups, parties, peoples, ages, it is the rule.” – decadence, and similar, but later developing concepts from psychology, anthropology, and some lines of critical theory.

    personally, i’m not well versed enough on the efficacy/competency (or lack thereof) of contact tracing to suggest whether romer is right on its already assured failure. generally speaking, the sense that trust in expertise is waning, and in some areas of life actively distrusted, is accurate. but this is by no means absolute or necessarily irreversible, imo, esp. in the realm of medicine and public health.

    what we do have is slowish motion legitimacy collapse of large scale institutions. he’s right to point to brexit and trump’s election as macro indicators or symptoms of deeper, harder to see social currents that remain willfully unexamined. insofar as he’s addressing the experts and exhorters as well as the institutions, governments, and corporations they work for with this plea, he’s really just acknowledging that painful fact.

    put another way, the experts, the politicians, the wall street titans and captains of private industry – those who should be best trained and most inclined to confront the hard edges of unvarnished reality without sentiment or illusions – are only capable of invoking dead, hollowed-out moral injunctions in response to this and other hard problems. ergo, the inadequacy of institutional evil as an analytical concept. these individuals and institutions lack the will, faith, or belief to commit evil, much less good, much less good in the name of evil or vice versa. it’s not just that swathes of public have lost trust and faith. the experts and institutions no longer have faith in themselves.

    at such historical moments, moral exhortation functionally becomes farce. no one cares, no one listens, no one believes.

    Reply
    1. flora

      Trying to decide if neoliberalism’s “because markets, go die” is evil or madness. If the upshot is “go die” then does it matter which one it is? ;)

      Reply
      1. cat’s paw

        well, it matters for analysis, potentially for tactics and strategy, certainly for historical understanding, and also for what was once known as wisdom.

        but as a practical matter, knowing whether the phenomena, activity, or system is evil, mad, senile, or inept usually proves quite useful.

        Reply
  4. Joe Well

    Zeynep Tufecki made a very good observation as to the secret of contact tracing success in East Asia: they trace retrospectively, which is better because most infected people don’t infect anyone else, while most infections come from super-spreading individuals.

    “Right now, many states and nations engage in what is called forward or prospective contact tracing. Once an infected person is identified, we try to find out with whom they interacted afterward so that we can warn, test, isolate, and quarantine these potential exposures. But that’s not the only way to trace contacts. And, because of overdispersion, it’s not necessarily where the most bang for the buck lies. Instead, in many cases, we should try to work backwards to see who first infected the subject.

    Because of overdispersion, most people will have been infected by someone who also infected other people, because only a small percentage of people infect many at a time, whereas most infect zero or maybe one person. As Adam Kucharski, an epidemiologist and the author of the book The Rules of Contagion, explained to me, if we can use retrospective contact tracing to find the person who infected our patient, and then trace the forward contacts of the infecting person, we are generally going to find a lot more cases compared with forward-tracing contacts of the infected patient, which will merely identify potential exposures, many of which will not happen anyway, because most transmission chains die out on their own.”

    Reply
    1. Lambert Strether Post author

      > if we can use retrospective contact tracing to find the person who infected our patient, and then trace the forward contacts of the infecting person, we are generally going to find a lot more cases compared with forward-tracing contacts of the infected patient

      If I understand this correctly, backtracking smokes out the super-spreaders (lowering k). Yes?

      Reply
      1. Robert Hahl

        That is how I read it. I also think that this point needs to be made very broadly, in separate posts, because it is not usually discussed by the lay public.

        Reply
      2. Susan the other

        Honestly, Lambert, I couldn’t tell who said what but I definitely liked the editor. And the quotes from Thomas Frank whom I have not yet read – re the 2008 massive criminal debacle: (those perps) “they still have their goddamn jobs.” And etc. But about herd immunity, this is what I’m thinking – herd immunity really is a pony – and we are smart enough to wonder how but too coarse physically (size wise) to observe it. Sorry – I’m lost in the Quantum these days. So I sorta think herd immunity is still a pony – it’s just a pony in progress! And I’d just like to scream this: We need to advance the known effective treatments which we do have like BCG, HIV, various vaccines, good fucking masks – not ineffective ones at $5 dollars a piece dear god; and clearly, since both Trump and Christie survived (with all their very old-fat-man vulnerabilities) we need to advance and make available at no cost treatments of monoclonal antibodies to COV=2 patients. It’s just a fucking-no-brainer – in a world free of neoliberal ideologies – But. We are stuck with an inability to see the obvious political path because Trump and Biden are both neoliberals. It becomes a question of averaging out the political (class) superficial differences and following the most beneficial path for every interest. It is very slow going. But it is, per capita, the quickest path the universe offers. But then we are left with an overpopulation problem. These things are becoming critical. Can we just talk?

        Reply
  5. Synoia

    Therw are a lot of deaths between us now and herd immunity. Roughly 10x the current number.

    Which assumes that Covid creates herd immunity.

    Reply
  6. ChrisPacific

    This strikes me less as an argument against the effectiveness of contact tracing and more as an argument about why the USA is currently unable to implement it.

    This post will not consider alternative (ii), nor does Romer. Of alternative (i) — where I am irresistably reminded of the liberal Democrat tendency to double down — Romer poses two more alternatives:

    Once again, we will not consider QN of fact 1; only QN of fact 2. There, the answer is a resounding “No!”

    If we accept that then the conclusion is that for contact tracing to ever be workable in the USA, we’d need to do a better job of making persuasion work. A reasonable starting point for that would be to ask why it’s not working now, and the answer to THAT question speaks to unique features of the US political system and trends that have been decades in the making (viz., that donor-financed propaganda has substituted for genuine policy debate in the public sphere for many years now, with the result that trust in official pronouncements is extremely low). It’s unfortunately not likely to be a quick fix.

    Reply
    1. Lambert Strether Post author

      I’m not sure what the argument is, here.

      > This strikes me less as an argument against the effectiveness of contact tracing and more as an argument about why the USA is currently unable to implement it.

      That is correct. Romer agrees that other countries have implemented contact tracing successfully, but that the United States currently cannot (and is “terrified” that they will not). He’s not in “assume a can-opener” mode, nor am I.

      > we’d need to do a better job of making persuasion work. A reasonable starting point for that would be to ask why it’s not working now, and the answer to THAT question speaks to unique features of the US political system

      That is correct. Romer has views on this (see the quoted tweets) and the post amplifies them; that Romer and Thomas Frank arrived at more or less the same place is pleasing to me.

      Reply
      1. ChrisPacific

        I don’t think I really have any disagreement with the article – I just found the title a bit ambiguous. It made it sound to me like I was going to read an argument against contact tracing, hence my reply. On review I see that the crucial part is actually “in the United States,” i.e., contact tracing isn’t broken but the US is.

        Whether I am in “assume a can opener” territory for suggesting that fixing the US might be possible, I’m not sure. Certainly I think there are ways Biden could approach contact tracing that might work, but most of them would require him to be somebody other than he is.

        Reply
  7. The Rev Kev

    Want to know what the big killer here is? Political expediency. So somebody like Fauci (wrong person by the way) should have been the public face of the Coronavirus task force. But through political expediency, he lied about masks and was unapologetic about it when he fessed up to lying. Maybe he thought that that was how it worked in the circles that he moves in – being politically expedient – but most people took it at breaking trust. And you either trust someone or you don’t. So now that Trump is blasting Fauci as a disaster, who will defend him? Who will trust his judgment?

    Doesn’t help having a bunch of ‘experts’ pushing for herd immunity as if people were cattle. There is no proof that it will even work but experts are saying that this is the way to go to protect the economy. Not people. The economy. Paul Romer may be a very intelligent person but he obviously has some blind spots as Lambert pointed out. So that is what I am trying to get at. When all these experts are giving their advice, is it because that this is the best advice that they can give or is it because it is the political expedient advice to give.

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    1. Carolinian

      is it because that this is the best advice that they can give or is it because it is the political expedient advice to give.

      Maybe it’s that this is supposed to be a “novel” disease and they don’t know the answers–at least not with certainty. Which is why some of us are skeptical of any claims of certainty.

      Reply
    2. Lambert Strether Post author

      > Want to know what the big killer here is? Political expediency

      Nope. Class interest; specifically, PMC class interest.

      My view of election 2020 — I think Trump is out of runway, feral though his ground operation may be — is that the Democrat Party, with its class basis in the PMC (see Thomas Frank) showed enormous political dominance, having seen off not one but two populist threats, one from the right and one from the left. (The Sanders campaign, and especially its funding model, has been carefully erased, though hilariously the Trump campaign is said to have adopted the Sanders technique of relational organizing.) In the day-to-day cut and thrust of politics*, Democrats compensate for the numerical weakness at the Democrat base — unlike the FDR coalition, the PMC is nowhere near a majority of the population** — with their control of the commanding heights of the media, an alliance with the intelligence community, and a structural requirement that our extremely broken systems all require highly-paid bubblegum and duct-tape operators with credenitials to run.

      If we think of Corey Robin’s idea that conservativism is “a meditation on lost power,” then we see clearly that the Resistance, leading to a Democrat Restoration led by the Obama Alumni Association, West Wing fans, and a necessary leavening of Bush-era war criminals, is a conservative reaction to Trump’s victory in 2016, with its concomitant rejection of Clinton, the “most qualified” candidate (and, as a [x] woman, a symbol of justice as conceived of by aspirational PMCs).

      Assuming a Biden victory, the PMC will have re-asserted their natural right to rule (in service of capital, too, let us not forget). How will they exercise this power? More concretely, how will the Biden campaign exercise its power in implementing Covid policy?

      History and PMC class interest together, as Romer argues and Frank shows, give the likely answer: “Not well.” Given past behavior, one would expect a doubling down on fingerwagging and shaming across the media spectrum, and (hence) a contact tracing program that doesn’t win the trust of those most in need of it. (Hero Fauci being lauded, because Orange Man bad, after having told his “noble lie” on mask effectiveness gives off a terrible stench of rot; what will “the experts” remorselessly lie about next, pray tell? Vaccine efficacy and safety?)

      Naturally, I pray that I’m wrong, and that Rule #2 of Neoliberalism does not apply.

      NOTE * That is, not at the level of abstraction required by Ferguson et al.’s industrial model, whose operations become evident only well after facts on the ground, because campaign finance is horridly obfuscated.

      NOTE ** And willful Democrat refusal to expand their base shows they have no intention to become so.

      Reply
      1. Carolinian

        I think you are quite right that the Dems are now the classic conservatives who live in fear of “the mob” and, yes, are about to install the latest Louis the Sixteenth in the person of barely still there Joe Biden. This may not be true of Democrats on the member level but is quite true of the leadership who share that other classic conservative trait of being very rich or aligned with the rich. No mob they.

        Reply
  8. ObjectiveFunction

    It’s all going according to plan!©

    The Plan, for those needing a PowerPoint (and perhaps a stiff drink or two):

    http://gracefulspoon.com/blog/2009/06/02/global-panopticon/

    The model of the parasite and host serves as a useful model for all forms of social, cultural and technological mediation…. The host cannot control the guest when the principle of altruism is primary….

    In feudalism, the body is punished (it’s the only property available). A mercantile economy results in forced labour and monetary fines….

    Punishment is shifted from vengeance of the sovereign to the defense of society….

    Most complex, immensely powerful machine we’ve already built. Set of rules and if/then statements. Evolves into unforeseeable result due to decisions made by many people (agents) as well as other machines on metadata….

    Increased influence of non-state corporate actors. State of emergency / state of exception allows this to thrive….

    (Fortunately for most of us, The Plan is being implemented via a public-private partnership so we’ll be in our graves before it is fully rolled out)

    Reply
  9. a different chris

    It’s OK to say something isn’t working.

    It’s OK to say “try something else” but not say what it would be. I think I’ve already made my “I don’t have to tell you how to fix something just because I see you’re doing it wrong” case enough here.

    The thing here is… Romer does not offer an alternative, and so in this particular case why shouldn’t Biden keep trying until one comes up? Maybe people will suddenly get with the program. It happens, that’s the theme of every sportsball movie ever made, and some of them are based on real life. Unless you can make a credible case that such an effort will actually cause damage (like building a highway nobody will likely use thru a nature preserve) then might as well keep sawing away until somebody comes up with (ii).

    He did touch on that with his “experts are no longer heeded” part, but if that ship has sailed then maybe that’s the time that they should really hold to their faith.* If you’re right, you’re right, medicine isn’t a popularity contest.

    He sounds frustrated and angry, as is understandable. He may be a bit of an elitist, though, if his view is really “we are consuming the time of the only people that are smart enough to figure out an alternative”.

    Everybody is thinking about this.

    *And this type of science does have a bit of faith at the bottom of it, we can count and count and multiply and divide but there are lots of weird orthogonal corners in human society that you just have to hope for the best about.

    Reply
    1. Lambert Strether Post author

      > Romer does not offer an alternative

      Read the thread; he does, in fact, but his alternative is not germane to the topic of this post, and so I did not go down that path. (That is why I carefully flagged the path I took!)

      Reply
  10. Mikel

    In the USA, they would have already implemented the mandates and sent out the contact tracers, without a second thought about their own legitimacy in the eyes of the population, but there’s that GUN issue…

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  11. VietnamVet

    Evil is knowing that a million or more Americans will have early deaths and not doing anything about it because it costs Billionaires and their Overseers money.

    There is a simple, one point, way to combat the Coronavirus Pandemic and the economic depression. Go to war. Restore a functional national government and public health system and fund it. Require universal daily antigen testing. Negative tests are necessary before going out in public. Schools, work places, and social gatherings (Communities) must form bubbles staffed with a public health officers who are in a chain of command and report up through the States to the US Surgeon General. Scofflaws will be found and isolated. The infected given safe housing, food, and free treatment. The campaign will take several months, cost money, but the virus would be eradicated. Returning the economy to normal is less costly than letting the virus run free.

    Reply
  12. Cuibono

    contact tracing fails here because it is not properly seen as part of a larger system of social support to those who are afflicted…we dont do that very well.
    contact tracers i know feel aggrieved that they are being asked to be social workers…and hence they fall on their faces…

    Reply
    1. SteveB

      Contact tracing: You mean an activity whereby I get a call from an unknown phone # asking where I’ve been, who I’ve had contact with and suggests I get tested. With a nice BTW call this number and arrange a test…….

      Why would anyone expect this to be successful when it sounds like anyone of a thousand phone SCAMS I receive every day. If a name in my contacts list doesn’t come up when it rings, I don’t answer.. Leave a message………………… and Maybe I’ll listen to my messages someday…when I get around to it….

      Reply
      1. Henry Moon Pie

        Exactly. What means of communication could contact tracing realistically use? Our fine Feds have allowed the telephone lines and airwaves to become so thoroughly jammed with scammers and bill collectors that the telephone is no longer a reliable way to communicate beyond the narrow circle that recognize your phone number.

        What’s becoming apparent is that The Virus will defeat not just Trump and the Traditionals but Obama and the Technocrats as well.

        It’s looking more and more like The Virus will become endemic and coping with it will involve some form of “pods” or affinity groups. For the majority who won’t realistically be able to do something along those lines, The Virus will just be another contributor to a declining life expectancy.

        Reply
        1. FluffytheObeseCat

          Contact tracing could and should be done exactly the same way we run the decennial census. With follow up by people if phone, mail, and email fail to elicit a response.

          We already have the techniques and personnel necessary to do it. The census just ended on October 15th. We had public health nurses in Nevada – an under funded state – who go to peoples houses if tuberculosis exposure is indicated. I know this because I received follow up in person in 2009 when my daughter was exposed in New York State. This system may have been dismantled over the past decade, but it was operational quite recently.

          The U.S. can do contact tracing. Most of the population answer the census if asked in person, and they will be about equally responsive to a contact tracing program. Most people do not haunt political talk boards, or even listen to talk radio. They’re mostly quietly sick of raging old men and google-eyed ‘Christian’ supermoms riding partisan hobby horses at the top of their lungs everywhere.

          If old addled Biden wins, it will be because the rightie ranters will have finally exceeded the PMC in their ability to endanger and annoy the normal majority.

          Reply
      2. Oh

        About a month ago I went to one of the chain salons for a haircut. They previously only asked for a name and phone no. (I gave fake ones). Now they wanted my address too. I asked them why they need it and I was told “for contact tracing because the CDC requires it”. I knew of no such requirement and I walked away. I should’ve given them a fake address too but I was infuriated that they would blatantly lie. The lengths to which the large corporations will go to for getting you data!

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  13. jackiebass

    Nothing will work without cooperation. There are a few reasons why people won’t cooperate.I think the biggest is the US had become a me only centered society.Every day I see people that do things that negatively effect others. They are in their own little world and oblivious to the world around them.
    Another is mis trust of government. People on all parts of the political spectrum don’t trust the government. Ronald Reagan unleashed this with his government can’t do anything right.
    Then you have the idea of personal responsibility, pushed by mostly conservatives. Unfortunately our society has deteriorated to the point where there no longer is a cooperative work together attitude. Instead we have wide spread disrespect illustrated by name calling. It has become very difficult to have a rational reasonable discussion on an issue with someone of a different view. Before covid I used to regularly visit a what could be labeled as a red neck bar. I did a lot of listening . This was my education about the people in my area. Right now I’m listening to the call in segment on CSPAN. If you want a real education about the US population tune in some day.

    Reply
  14. Bob Hertz

    Seems to me that ‘testing and tracing’ will not stop the pandemic unless we add ‘quarantining.’

    Successful quarantining takes real money for the hotels, food, and wage replacement funds. Not sure this could get past Congress. (although we have spent far more money on the virus already.)

    Then there will be a civil-liberties resistance. People who won’t even wear masks are not going to go peacefully into quarantine.

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  15. Todd

    This discussion reminds me of the protestor who lost his legs to a slow moving train. The train operators could never stop the train in time. You can’t change the laws of physics. I think, even if the protester had been told about the immutable facts about stopping the train he still would have lain down. At the end of the day no one’s ideas are changed and you have someone with two less legs.

    The virus is like the train it’s immutable in it’s facts. They can not be changed. Like wise the Anti mask’s, anti social distancing etc, will not change. We are going to be left with carnage.

    We do not know what the distribution curve of conferred immunity is but the left tail of the curve starts at ~6 mos. It’s not years or life time immunity like chicken pox, mumps, measles etc. It is more like the cold and flu. Only temporary.

    I believe herd immunity is a windmill that Don Quixote would be proud of. It’s a pipe dream and will never be achieved except under the most dire sequence of events. While this virus spread is fast, it will not spread fast enough to infect and burn through everyone or even 70+% of the population in less than 6 months. The conferred immunity curve starts at ~6 mos. In my opinion, pushing for herd immunity is akin to pushing for the apocalypse. You can not achieve herd immunity at a country level, it would have to be global.

    It does make me sad and at the same time filled with wonder. I’ve always wondered what people were thinking in the past that would lead them to the events in the different major turning points in history. Now we know, for we are living it today.

    Reply
  16. stefan

    The best philosophical distinction of Good/Evil versus Good/Bad can probably be found in Spinoza. I can’t do justice to his argument here because Spinoza’a reasoning is exquisitely precise, but the gist of it is that good/evil are merely moralistic ascriptions, whereas good/bad refer to the practical affect on/of the body, have real world meaning. And bodies differ. For instance, salt water is good for sharks, but poison for freshwater fish. So is salt water evil?

    Reply

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