Tag: policy

Lockdown Effectiveness

1: Various policies lumped together as “lockdowns” probably significantly decreased R. Full-blown stay-at home orders were less important than targeted policies like school closures and banning large gatherings. Talking about which ones were “good” or “bad” is an oversimplification compared to the more useful questions of when countries should have started vs. stopped each to be on some kind of Pareto frontier of lives saved vs. cost.

2: If Sweden had a stronger lockdown more like those of other European countries, it probably could have reduced its death rate by 50-80%, saving 2500+ lives.

3: On a very naive comparison, US states with stricter lockdowns had ~20% lower death rates than states with weaker ones, and ~0.6% more GDP decline. There are high error bars on both those estimates.

4: Judging lockdowns by traditional measures of economic significance, moving from a US red-state level of lockdown to a US blue-state level of lockdown is in the range normally associated with interventions that are debatably cost-effective/utility-positive, with error bars including “obviously good” and “pretty bad”. It’s harder to estimate for Sweden, but plausibly for them to move to a more European-typical level of lockdown in the early phase of the pandemic would have very much cleared the bar and been unambiguously cost effective/utility-positive.

5: It’s harder to justify strict lockdowns in terms of the non-economic suffering produced. Even assumptions skewed to be maximally pro-strict-lockdown, eg where strict lockdowns would have prevented every single coronavirus case, suggest that it would have taken dozens of months of somewhat stricter lockdown to save one month of healthy life. This might still be justifiable if present strict lockdowns now prevented future strict lockdowns (mandated or voluntary), which might be true in Europe but doesn’t seem as true in the US.

6: Plausibly, really well-targeted lockdowns could have been better along every dimension than either strong-lockdown areas’ strong lockdowns or weak-lockdown areas’ weak lockdowns, and we should support the people trying to figure out how to do that.

7: All of this is very speculative and affected by a lot of factors, and the error bars are very wide.

Human Challenge Trials

we need far more human challenge trials, and far less garbage people like ethicists.

In interviews, former challenge trial participants described motives for their participation that ranged from the light-hearted — several imagined it would be a fun story to tell at scientific conferences and parties — to the serious. Some spoke of altruistic motives, often shaped by personal experiences. “I spent a couple years in Africa; I was in the Peace Corps. I think for me, seeing that firsthand, and knowing that there might be some way that maybe I can be a part of figuring out whether or not we can make a vaccine for malaria definitely played a big part in it for me.”

Patrick Collison Interview

We perhaps shifted from placing emphasis on our collective effectiveness in advancing prosperity and opportunity for people to the perceived fairness that was embodied in whichever particular steps we happened to take. We shifted our focus from sins of omission to sins of commission. Take California: there is almost endless attention paid to making sure that no single state project has even a tint of impropriety or suboptimality. The result of that cultural shift, is that the state as a whole is then often beset with awful results. With this ethos and panoply of strictures, it turns out that California is almost functionally incapable of constructing a high speed rail line connecting its 2 major metro regions. California has less civilizational capacity than the France of the 70s that built the TGV! California shifted mid century from being the US’s fastest-growing state — 50% population growth between 1950 and 1960 — to a state that is somehow, improbably, shrinking. This is, obviously, mostly because of the regulations the state’s inhabitants put in place that block the housing that’s required to support California’s economic success. As a result, California has lost the “technology” of being able to affordably house its inhabitants.

Libertarians in a Pandemic

The COVID-19 pandemic had barely taken hold in the United States when principled libertarianism was reported to be among the early fatalities. “There are no libertarians in a pandemic,” Atlantic writer Derek Thompson quipped on Twitter on March 3. But that doesn’t mean libertarians haven’t made valuable contributions to the discourse surrounding COVID.

Paul Romer argued early on that government investment in massively expanded testing would be a bargain compared to the costs of letting the pandemic rage unabated. And this is one subsidy that many libertarian public voices eagerly endorsed. Yet the government is doing worse than nothing about these tests. Not only has the government neglected to subsidize them, it has put up obstacles so citizens can’t pay for them. Regulations are actively denying individuals access to valuable information about their own bodies that would help them avoid unknowingly spreading the disease.

More than 800 regulations were waived in response to COVID. While some of these will eventually come back into force, the pandemic has revealed how we’re better off without them.

Is there anything specifically libertarian about different dosing strategies? Not inherently. But the ideas owe much of their currency to the advocacy of George Mason economist Alex Tabarrok, and the debate centers on whether the bureaucratic decision-making processes of the FDA are adequate for responding to the current crisis. FDA procedures are designed for drug development and the certainty provided by time-consuming randomized control trials. As with early advice on masks and current restrictions on at-home testing, these standards may not serve us well in a rapidly progressing pandemic.

Better Masks

We need the CDC and the FDA to step up and provide simple, clear, actionable, and specific information that would allow the public to know which masks are reliable and where they can get them, as well as how to upgrade and better wear their existing options.

instead of sitting on their hands running out the clock on vaccine approvals (astrazeneca is still not approved), some mask guidance would be good. instead, everyone at these agencies seems to be playing virtue signaling games to impress their coworkers.

Thoughts on China

This emphasis on growth makes it less likely for China to develop into American complacency or decadence. There are other types of paralysis that it stands a good chance of avoiding. With its emphasis on the real economy, it is trying to avoid the fate of Hong Kong, where local elites have reorganized the productive forces completely around sustaining high property prices and managing mainland liquidity flows. With its emphasis on economic growth, it cannot be like Taiwan, whose single bright corporate beacon is surrounded by a mass of firms undergoing genteel decline. With its emphasis on manufacturing, it cannot be like the UK, which is so successful in the sounding-clever industries—television, journalism, finance, and universities—while seeing a falling share of R&D intensity and a global loss of standing among its largest firms.

2021 edition:

An important factor in China’s reform program includes not only a willingness to reshape the strategic landscape—like promoting manufacturing over the internet—but also a discernment of which foreign trends to resist. These include excessive globalization and financialization. Beijing diagnosed the problems with financialization earlier than the US, where the problem is now endemic. The leadership is targeting a high level of manufacturing output, rejecting the notion of comparative advantage. That static model constructed by economists with the aim of seducing undergrads has leaked out of the lecture hall and morphed into a political justification for only watching as American communities of engineering practice dissolved. And Beijing today looks prescient for having kept out the US social media companies that continuously infuriate their home government.

US climate innovation

To reduce duplication, focus the government’s efforts, and get the most innovation out of every $ of funding, we should create a new organization, the National Institutes of Energy Innovation. This the most important thing the US can do to lead the world in innovations that will solve climate change. Creating these institutes wouldn’t be an exercise in simply moving boxes around an organizational chart and hoping for a better outcome. We actually have a model for setting things up in a better way, and evidence that it produces results. That model is the National Institutes of Health. The NIH is the largest single funder of biomedical research in the world, and its impact is simply mind-blowing. Scientists supported by the NIH have mapped the human genome, resulting in tests or treatments for 10s of genetic diseases. They have helped cut deaths from heart disease by 66% in the past 50 years. Since 1980, NIH-supported research has contributed to the discovery of more than 150 new drugs, vaccines, and novel uses for existing drugs. The Gates Foundation’s work in global health simply would not be possible without the countless advances made by the NIH.

Why is the NIH so successful? It has a clear and specific mission. It has apolitical leaders who let independent researchers follow the science, rather than political staff who change priorities every few years. It’s organized in a way that empowers each of its separate institutes and research centers. And it has strong bipartisan support from policymakers and the public.

Warp Speed is Normal

one big reason we got vaccines so quickly was that work had already gone into coronaviruses:

That was a really good—well, not “guess,” I suppose, but a good hypothesis, right? That a coronavirus was going to be a problem?

We were hedging our bets. No one knew what the next outbreak would be. It could have been a variant of influenza; it could have been one of a number of pathogens. But yeah, the short answer is, if you look at a list of outbreaks over the last 20 years, if 2 of the viruses on the list are in the coronavirus family, then you shouldn’t be shocked that it comes up again. SARS was 2002. MERS was 2012. In pandemic history, that’s a pretty short timeframe.

So we did some work with Moderna on designing MERS vaccines—all early, preclinical—so we were able to test how our mRNA worked, and we could test some designs on what the RNA should teach the body to make an immune response against. We had a lot of groundwork already laid when we found out the new virus was a coronavirus.

to prepare for the next pandemic:

It took nearly 20 years to understand coronaviruses well enough to work on. But what if the next one’s not a coronavirus?

There’s a reasonable possibility that a virus could emerge from a different virus family, and we would not be as prepared. We know that there are ~20 major virus families in the world that infect humans, and almost every outbreak we’ve seen in the past 50 years or more has come from one of those 20 virus families. What if we made a concerted effort to study every family in detail, to make vaccines to every family, and do what we did for coronavirus? Make some prototypes. So that if a cousin in that family emerges, a virus we’ve never seen before, we at least have laid some groundwork for vaccine design. One could, for $20m per virus family, make a prototype vaccine and test in the clinic. You’re talking a few billion $ over 5 years for that kind of project. That used to seem like it wouldn’t be tenable. But now it’s like, well, if I could be prepared for the next pandemic, that’s probably a really good investment.

Did NIMBYs Save Cities?

When the city is surrounded by suburbs that make new development even harder, that can make those undertakings more attractive.

Once investment is forced back into the city, NIMBYism continues to serve a useful purpose, keeping property values high, providing the city with higher tax revenues that can be invested into schools and improvements. One problem cities like St. Louis or Akron have is that their homes aren’t valuable enough for banks to lend money to the owners and produce very little in tax revenue. Detroit has one of the highest tax rates in the country.

Makes the strange argument that NIMBYism in the suburbs should lead to YIMBYism in the cities, creating a “green belt” around cities. Interesting theory, but I see no evidence that there’s really a YIMBY trend in cities.
2022-06-01: And YIMBYs are extremely ineffective because they pretend.

The notion that resistance to development is driven by rich white people is absurd on its face. It’s a joke, a farce. It’s just not true. YIMBYs have to decide if they want to be an authentic political force, which means accepting complexity and the inevitability of moderation and compromise, or if they’d rather just keep flinging shit on the internet. The latter is certainly more fun. But we desperately need a mature, goal-oriented YIMBY movement. We’re in a housing crisis, and while “just build!” has always been an inadequate philosophy, we must build and build a lot to get out of this housing hell. To do that YIMBYs have to be willing to look working-class Black and brown NIMBYs in the eye and, when appropriate, say “your objection to this project is misguided and wrong.” That’s less fun than dunking on Twitter. But it’s a necessary next stage of their project, if it’s to succeed.