Saturday, March 7, 2020

COVID-19 # 22 (Required Parts are Highlighted)

Columbia and Princeton have both shut down face-to-face classes.

The President of Portugal has self-quarantined after an exposure. So have a few members of Congress. In New York City, the head of the Port Authority (a very, very, large quasi-governmental organization) has tested positive.

The CDC has asked that all students from American universities that are currently studying abroad — no matter the location — be brought back. Read between the lines: that's an implication that it in the near future it may not be possible to bring them back, presumably due to flight cancellations.

More data on the scale of the economic downturn in China: cellphone sales were down by 50% in February.That's compared to a year ago. Interestingly, cellphone sales were also down in January, December, and a littl ebit in November, suggesting that China may have been going into recession before COVID-19 hit. Also, there are seasonal fluctuations in cellphone sales in China, and February is the lowest month. Who knew?

You've probably heard about crude oil prices: down about 40% since Friday. You can check the price charts here. What's going on here is well-explained by the oligopoly and game theory coverage you've hopefully received in other classes. OPEC is a cartel. It works through collusion: members agree to jointly reduce production to keep prices high. This is a form of prisoners' dilemma: the policy choices are to collude or not collude, the desirable outcome is for everyone to collude, but the Nash equilibrium is for no one to collude. When that happens, artificially inflated prices will collapse. Do note that none of the price changes so far are about too much oil being produced; instead, they are about the expectation that too much oil will be produced, and no one will have a place to store it.

Social distancing is the new buzzword. Stand further apart. Fist bump. Eat alone. Wash your hands a lot. Don't touch your face. Wear a mask if you must (but the evidence is not good that these do any good — they go on sick people not well people). Great tweet storm here on why soap works. Also, pay attention to how doctors wash their hands in every video you've ever seen: regular people spend too much time on their palms, and not enough on the backs of their hands.

Absolutely huge implications to the article entitled "How It All Started: China's Early Coronavirus Missteps" that appeared in The Wall Street Journal on Friday:
It now appears that, based on a speech by Mr. Xi published in a Communist Party magazine in February, he was leading the epidemic response when Wuhan went ahead with New Year celebrations despite the risk of wider infections. He was also leading the response when authorities let some five million people leave Wuhan without screening, and when they waited until Jan. 20 to announce the virus was spreading between humans.
As a result, the virus spread much more widely than it might have ...
 ...
It now appears that he was in charge of the response since at least a Jan. 7 meeting of the party’s top leadership, a change in the narrative that was made public in February as public anger mounted at a perceived lack of leadership from Beijing.
Chinese doctors and scientists said there were errors and foot-dragging by some experts sent by the government to Wuhan.
Among those sent in early and mid-January was Peking University’s Wang Guangfa, who told official media on Jan. 10 that the virus had little capacity to cause illness and the epidemic was under control. Dr. Wang, who declined to comment, announced later that he had caught the virus.
Some of the experts had access to the first 41 confirmed cases at Jinyintan but were reluctant to share data with others before publication in a prestigious medical journal, according to some doctors and scientists involved in the response.
“Everyone was beginning to prepare for similar cases in other provinces and yet had no firsthand information on the virus and how it worked,” said a doctor who repeatedly asked for more clinical details and was brushed off. “Doctors across China were really angry about this.”
Another doctor involved said Chinese authorities had been looking solely for evidence that the virus was spreading from patients to medical workers, overlooking signs that it was moving between patients, their relatives and others they came into contact with.
With international concern mounting and China’s health authorities receiving reports of fresh cases in Wuhan and some other cities, Beijing sent a new team of experts to Wuhan on Jan. 18, the day of the Lunar New Year banquet.
That team included an infectious disease expert from Hong Kong who had reported the day before that human-to-human transmission occurred in a family from the city of Shenzhen who had visited relatives in Wuhan but had not been to the Hua’nan market.
It also included Dr. Zhong, as the leader of the task force, who had played a key role in combating SARS. Among the evidence local doctors presented to Dr. Zhong was that of a single patient who had infected 14 medical workers at Xiehe Hospital, according to that hospital’s emergency chief.
Still, when President Xi made his first public statement on the crisis on Jan. 20, he made no explicit mention of human-to-human transmission, even as he told officials it was vital to contain the virus during the Lunar New Year travel period.
A few hours later, it was Dr. Zhong who announced on Chinese state television that the coronavirus was indeed spreading between people.
His team privately informed the Chinese leadership that the situation was more dire than they realized, and presented a series of recommendations, including as a Plan B, locking down Wuhan, according to a city official familiar with the discussions.
As a WHO committee met in Geneva to discuss whether to declare a global emergency, President Xi went for Plan B, imposing a cordon sanitaire on Jan. 23 on Wuhan and three other cities
Oh, and by the way, The Wall Street Journal broke the news of the outbreak in the legacy media on January 8th, fully 2 days before any announcement by the government of China. And in America we think Trump is not acting appropriately? The whole article does a good job of going through the good decisions made in China in December and January, as well as the bad ones.

This is pure speculation on my part. Chinese media revisionism about the role of Xi began after the ejection from China of 3 reporters from The Wall Street Journal. All were working Beijing, not in areas harder hit by COVID-19. A couple of weeks later this rather comprehensive article appeared in print. I wonder if those reporters were digging for information about the role Xi played in early January??

Meanwhile, Chinese media increasingly portrays Xi as a hero.
State media recently backdated Mr. Xi’s first known instructions on epidemic controls by nearly two weeks, to early January.
...
When news circulated in late December and early January about a new and deadly strain of pneumonia emerging in Wuhan, Mr. Xi made no public mention of the outbreak and stuck to his official schedule, which included a trip to Myanmar.
His first public remarks on the contagion came on Jan. 20—three weeks after China first reported the pneumonia to the World Health Organization ...

Outside of China, the internet never forgets. We know when Xi started taking actions.

Taiwan has done a very good job of containing their outbreak. Through February 21st, here is a list of 124 separate policy actions undertaken to manage the outbreak (this is a link to the whole article, click the link at the end of the introductory section to get to the list).

I am not commenting about the Trump administrations performance much because I think the whole country is largely incapable of responding to that information accurately (that's both sides of the political spectrum). Having said that, this disturbs me:
So, pay attention to the location of Trump administration press conferences.


This is not good:
Going forward, please tell others your class was covering the outbreak when it was still only in China.

There is good news:
So, this will be like chicken pox: you get it once, and you're done. The bad side of this is influenza: it mutates enough that this process doesn't work very well. Let's hope SARS-CoV-2 does not follow that route. Unfortunately, the 2 in that name indicates that it already does, but not nearly as quickly as influenza.

Stanford University, one of the few schools still on the quarter system, is going online for the remainder of its Winter term. Their Spring Quarter starts on the 30th.

 Italy has quarantined about a quarter of the country (17 million people), for a month. There were reports over the weekend that retired doctors were being asked to come back to work, and that nursing students were being put on full time jobs. The region quarantined is Italy's richest in per capita terms, and the second richest region in aggregate terms in all of western Europe.
The quarantined area is the only one in the second darkest shade of blue in Italy, plus some parts of the surrounding regions in the third highest shade.

On Friday, I noted in that day's post that Slovakia was the only country in Europe without a case. Not any more.

Saudi Arabia has quarantined a governorate called Qatif. Governorate does not have an analog in how Americans think about our government: it's larger than a county, but smaller than a state. This particular one is right across the bay from the countries of Bahrain and Qatar.

Lebanon has announced it will default on its international debt on Monday (see the other post nearby). This is not good, since Lebanon already has cases of SARS-CoV-2.

The U.S. Army has suspended all travel from Italy and South Korea for soldiers and their families.

South Korea has also quarantined the region around the city of Daegu. In a post the other day I noted that they have 2K people in Daegu waiting for hospital beds.

South by Southwest was cancelled on Friday. (This is a music/arts festival in Austin held every March. The economic impact on the city is estimated to be just over half of that for hosting a Super Bowl or Final Four; except that other cities fight for those events, and usually get one every ten years or so).

Another one of those infected government officials in Iran has died. And there's a head of a smaller political party in Italy who tested positive.

And, AIPAC (a conservative lobbying group) held a large conference in D.C. last week. Several individuals who attended have now tested positive. Vice President Pence was the keynote speaker. Also in attendance were Secretary of State Pompeo, and Senate Majority Leader Mitch McConnell. Those 3 have not tested positive. Roughly 2/3 of the members of Congress also attended. Also, someone from the CPAC2020 conference, attended by both Trump and Pence, has been diagnosed. There are reports that Trump's "Kevin Bacon Number" with the positively tested person is two.

OK. Time to review: the Spanish Flu epidemic of 1918-20 is estimated to have killed 15-100 million people worldwide; that's between 1% and 6% of the global population at that time. Professor Christensen brought this to my attention last Thursday:
A Harvard University epidemiologist says that as much as 70 percent of the world’s population could get the coronavirus. Marc Lipsitch told CBS News in an interview airing Monday that "40 to 70 percent" of the global population could become infected with coronavirus and that it’s “almost inevitable” that the virus will impact the “entire globe.” He added that 1 percent of those who develop symptoms could die.
Just ballparking here: global population of 8,000 million, say half of them get the virus so that's 4,000 million, and 1% of them die that's 40 million. That number is right in the center of the Spanish Flu range.

Also, in an earlier post, I cited one of the definitive works on the costs of SARS in 2002-3. Now, keep in mind, you can't estimate what didn't take place. So we can't make a direct estimate of the costs, because we don't have a baseline of no-SARS to compare it to. I used those to ballpark costs of a few hundred billion dollars to China. But what we can do is run a simulation and produce some counterfactuals. Anyway, those authors have come out with simulations for the effects of COVID-19. Here's what they found:
In a high-severity scenario, the estimated loss to GDP in Australia in 2020 is $US103 billion, with many deaths. Under the same scenario, the global economic outlook is dire:
  • China’s loss to GDP in 2020 is estimated at $US1.6 trillion.
  • In the United States, the figure is $US1.7 trillion.
  • Japan’s estimated loss to GDP is $US549 billion.
  • In India loss to GDP in 2020 is estimated at $US567 billion.
“Our scenarios show that even a contained outbreak could significantly impact the global economy in the short run,” Professor McKibbin said.
Keep in mind: worst case scenario.

Hugely important article published in the New England Journal of Medicine (arguably the premier medical journal in the world). The paper has several dozen authors, many of whom are from China's CDC; presumably they have the biggest data set of anyone. It's mostly about the early stages of the outbreak. Here's the interesting bits:

  • Four of the first 5 cases had zero connection to the Huanan wet market, including the first two.
  • 26% of cases before January 1 had no connection to the market, or to another infected person.
  • By January 11th, 3% of cases were in healthcare workers (who presumably had better protection and cleanliness habits).
They also included this chart:

Keep in mind this important note from the authors: the paper was submitted several weeks ago, so the decline to the right of the peak in the chart is because the new people getting infected hadn't had tests yet at the time of submission. The true number of cases would continue to the compounded growth curve to the left of the peak.

Useful piece in the MIT Technology Review ranking 10 publicly available outbreak dashboards (the Johns Hopkins one is only ranked third).

Useful tweat storm doing some back of the envelope calculations:
She argues that we are looking at turning away sick people from hospitals in the U.S. by the first week of May.

Officially, Comic-Con is the big and original one in San Diego. That name has been copied by unaffiliated conventions held elsewhere. One of the largest was to be in Seattle this month. It's been cancelled too.

There are internet rumors going on about economists advocating that we should infect people intentionally. Please read the first several comments in this thread:
There is no certification required to call yourself an economist. That can be a problem for people like us trying to think fruitfully about how things are going to work out. I am particularly frosted that this particular tweet was from someone working in a field that aggressively defends the market power conferred by their certifications.

I'll be working on this one up until class time on Monday.
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