Friday, February 7, 2020

COVID-19 #09 (Required Parts are Highlighted)

It’s early Friday evening. Four pieces came up that may interest you.
First, the beginning of the NPR show Planet Money was about the possible effects of the coronavirus outbreak on the U.S. economy. You can listen to it here, under the show's title “Uber’s Path to Profitability”.
Second, one of the things they mention in that piece is “black swan” event. This concept gained modern prominence from Nicholas Nassem Taleb’s book, that seemed to eerily predict the 2007-9 financial crisis, entitled The Black Swan. The name comes from the assertion amongst Europeans, going back about 2,000 years to the Romans, that all swans were white and therefore black ones were impossible. Until they were observed in Australia in the late 17th century that is. Taleb uses the black swan as a metaphor for macro-outcomes being influenced by events that could not be foreseen, and further seemed beyond the realm of possibility. The NPR show worries that the coronavirus epidemic may be a black swan.
This leads to the third item. The Federal Reserve released a semiannual report on Friday afternoon noting that:
… Possible spillovers from the effects of the coronavirus in China have presented a new risk to the outlook.
The recent emergence of the coronavirus could lead to disruptions in China that spill over to the rest of the global economy …
That does not sound like too big a deal, except that the Fed normally makes its semiannual reports in fairly dry and non-specific language, unlike these two instances.
Lastly, I missed a point that comes up in a lot of international comparisons involving health risks and deaths: doctors in different countries list causes of death differently. This is from the Reddit thread I linked to earlier:
It is true that the death rate reported by China is heavily misleading. But this is NOT due to an active cover-up. There are 2 main structural reasons:
  1. This is primarily due to the structural method of how China records deaths on their certificate. It is established policy/practice in China to record the final cause of death, rather than all existing conditions and overlapping factors.
For example, if a (say 85 yo) patient in the US with diabetes and an existing heart condition gets nCoV, is admitted in the hospital, is confirmed with nCoV, then dies of heart failure, he is recorded as dying of nCoV AND heart failure with other complications. However if the same patient dies in China, he would only be recorded of dying by heart failure.
This is a well-known issue with China and co-morbid diseases. I don't agree with it, I wouldn't do it, but I don't run China. But this is not a new method they made up to try to hide deaths here, it's just the way it's done. This has led to jokes in the epidemiology community that "it's impossible to die of flu in China", because they basically don't record any deaths where the patient has flu. See here this recent article from the Global Times, which is one of China's state-sponsored newspapers.
This is not something even China is really trying to hide. They just tell us, sorry, our doctors just do things this way, we have no interest in changing it.


So, pretty much if this outbreak has started in the U.S. and followed the same course, death rates would have been much higher. Data weirdness like this is a regular part of doing cross-country comparisons on any subject.

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